The purpose of this investigation is to conduct a randomized controlled trial within a
subgroup of difficult-to-treat patients with CRS, evaluating the use of topical xylitol
treatment concurrently with topical steroid/antibiotics combination in the effort to disrupt
biofilms and improve disease control. The effectiveness of topical surfactants is a research
gap in treating CRS but has promising correlates in other medical fields. Specifically, the
investigators will be studying the effect of topical xylitol therapy on biofilm production
with the use of PCR bacterial sequencing before and after medical intervention.