Hamada K, Oishi K, Chikumoto A, et al. - Given an improved asthma control is attainable with endoscopic sinus surgery (ESS) in chronic rhinosinusitis with nasal polyps (CRSwNP) patients with asthma, but there is a lack of clarity about the mechanism that underlies the response to surgical treatment, therefore, researchers assessed the significance of changes in asthma control and alterations in airway/systemic inflammation among eosinophilic CRSwNP patients with not well-controlled asthma who had ESS. This study included 25 cases. Experts reported that the asthma control questionnaire (ACQ) score, blood eosinophil counts, and fraction of exhaled nitric oxide (FeNO) reduced, and forced expiratory volume in 1 s improved significantly following ESS. During baseline to 52 weeks post-ESS, there was a significant correlation of ACQ changes with the alterations in blood eosinophil counts and FeNO. At 52-weeks post-ESS, consistently improved asthma control was noted in 10 cases. In the rest of the cases, temporary improvement in the ACQ score was noted at 8-weeks post-ESS, but an eventual decline was evident at 52-weeks. Long-term improved asthma control post-ESS was reported in relation to higher levels of total immunoglobulin E. Findings revealed that sinus surgery influenced asthma control via the suppression of airway/systemic type 2 inflammation in eosinophilic CRSwNP patients with asthma. The common pathophysiology of type 2 inflammation between the upper and lower airways was strengthened by this work.