Removal of sinus polyps

How do we determine what the root cause of what polyps is? I had endoscopic surgery in March 2018 to.remove polyps and it made things worse for me. For the past 18 months I am unable to exercise, my asthma that I had as a child more than 30 years ago has suddenly come back. The coughing is crazy, the routine is get sick go to the doctor get prescribed for antibiotics and prednisone, relief for a while and the cycle continues. I have done an allergy test and have found that I am allergic to dust mites. How do.I prevent polyps from coming back. Not too mention that I have picked up a lot of weight due to my lifestyle change. If I am in an air conditioned room my symptoms get worse. What do I do? Would taking antihistamines continuously prevent polyps or sinus infections? I'm seeing an ENT specialist in a weeks time. Would surgery again be an option? A CT scan 2 weeks ago showed blockage of polyps in my sinuses totally. The first surgery in 2018 included removal of polyps and reduction of turbinates. This is what the current ENT has told me. Any advice would be appreciated.

I have had ENT issue's since I was a child.
I was operated on a three years old, what the exact procedure was, not sure.
Procedure was done in Azores, remote Island in the Atlantic.
Growing up always caught a cold or two in the winter months. I'm sure it had something to do with sinus issues.
Forward fifty plus years, decided I was going to do something about it.
Diagnoses : Polyps found and mild deviated septum
Doctor did not recommend surgery for either.
Polyps treatment: Recommendation, nasal rinse morning/night, nasal spray and antibiotic's for ninety days (90).
Doctor is telling me this may cure or get rid of my polyps.
Anyone had similar situation and treatment, and what was the outcome.

Thank you, O Tavares

ok. i have had surgery done twice per nostril. plus repair for a deviated septum, once. during that time no packing of the nose. just little strips like bandages that dissolved. or came out when i rinsed out my nose. using Neil Med solution with distilled water and a squeeze bottle. this took care of my polyps. but i was put on Dupixent 300mg/2L shots. every 2 weeks. to keep the polyps clear. works great for ME.

I’ve had years when I have been on antibiotics most of the year. Cold and allergy seasons every spring and fall are bad. Wind or a fan will cause it too because I’ve read it overstimulates the sinuses. I had sinus surgery in 2010 to repair a deviated septum that was so bad there was barely any airflow. The ENT also did turbinate reduction and ballon sinuplasty at that time. I didn’t have polyps that time. Surgery wasn’t nearly as bad as I expected. The discomfort was mild compared to the sinus headaches I’d had. It helped immensely and if I needed meds it was only seasonally. 2022 I couldn’t get rid of the sinus infections and after a year of antibiotics I had sinus surgery again in December 2022. Every sinus opening was blocked 100% with polyps. The worst the ENT had seen. She said they usually come back and dupixent works great. It is very expensive and she said you usually take it for life. I am not taking it. I had 3 polyps come back right after surgery which is common I’m told. She gave me samples of Exhance nasal spray which got rid of them. A year later I do not have any polyps. I take an allergy pill every morning and evening. (Generic Zyrtec, Sams, etc. very cheap). I also take 10 mg of singular (generic) which the ENT said can help prevent polyps. Grandson had a polyp and his doctor gave him singular and it went away. I use nasal rinses twice a day. I invested in a Navage and it is much better then the neti pot or bottle in my opinion. I use the Neil med packets instead of the Navage salt pots because they are much cheaper. There’s a hack of how to use them online. I use fluticasone nasal spray once a day. Good luck getting rid of them without having surgery!