title: Sinonasal outcome under aspirin desensitization following functional endoscopic sinus surgery in patients with aspirin triad.
abstract: Recalcitrant forms of recurrent nasal polyposis are problematic for patients as for rhinosurgeons. In aspirin-sensitive patients, aspirin desensitization is supposed to prevent recurrence by targeting the metabolism of arachidonic acid. Aspirin-sensitive patients (n = 65) following aspirin desensitization after functional endoscopic sinus surgery (FESS) for recurrent nasal polyposis under daily intake of 500-mg aspirin were compared to a post-FESS group (n = 81) of aspirin-sensitive individuals using exclusively topical mometasone. Quality of life (QoL) scores including sinonasal, pulmonal and general QoL items as well as endoscopic endonasal examination findings were evaluated during the postoperative follow-up period. After a follow-up period of minimum 18 months, a significant improvement in nasal obstruction, rhinorrhea, post nasal drip, sense of smell, facial pain, sleep quality and further general QoL items in desensitized patients was found compared to aspirin-sensitive controls. Improvement in sinonasal symptoms was evident, whereas the severity of asthmatic symptoms showed no significant changes. Although the pathophysiology of aspirin sensitivity is still not fully understood and the therapy is not sufficiently investigated, aspirin desensitization seems to have a positive effect on QoL scores concerning sinonasal symptoms and should be regarded as a possible postoperative treatment modality for recurrent nasal polyposis in aspirin-sensitive individuals.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Munich University Hospital, Marchioninistrasse 15, 81377 Munich, Germany. miriam.havel@med.uni-muenchen.de
authors.forename: Miriam
authors.initials: M
authors.lastname: Havel
authors.forename: Lena
authors.initials: L
authors.lastname: Ertl
authors.forename: Franziska
authors.initials: F
authors.lastname: Braunschweig
authors.forename: Sabine
authors.initials: S
authors.lastname: Markmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Leunig
authors.forename: Fernando
authors.initials: F
authors.lastname: Gamarra
authors.forename: Matthias F
authors.initials: MF
authors.lastname: Kramer
mesh_terms: D000328:Adult; D001241:Aspirin / Q000009:adverse effects / Q000276:immunology*; D055963:Asthma, Aspirin-Induced / Q000150:complications*; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000276:immunology / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D001241:Aspirin