Chronic rhinosinusitis (CRS) is a disease process defined by at least 12 weeks of symptoms, consisting of at least two of the following: facial pain or pressure, anosmia, anterior/posterior rhinorrhea, and nasal congestion. In addition, patients must show objective evidence of mucosal inflammation on either nasal endoscopy or computed tomography (CT). CRS is classically divided into two clinical phenotypes, CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). The prevalence of CRS varies throughout the world. CRS is often treated in a multi-faceted approach, combining various medical therapies and surgical interventions. These interventions often result in symptom reduction and improvement in quality of life for 85% of patients [9]. However, the remaining 15% of patients suffer from recalcitrant disease and require other medical regimens and interventions. A better understanding of the complex interplay between extrinsic environmental exposures and intrinsic immune system factors may help us better explain the pathogenesis of the condition and why recalcitrant disease is difficult to treat.