title: Long-term sinonasal outcomes of aspirin desensitization in aspirin exacerbated respiratory disease.
abstract: OBJECTIVE
  This study aimed to assess sinonasal outcomes in patients with aspirin exacerbated respiratory disease (AERD) undergoing aspirin desensitization following endoscopic sinus surgery (ESS).
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A retrospective review of sinonasal outcomes was conducted for 30 AERD patients undergoing aspirin desensitization and maintenance therapy following ESS. Sinonasal outcomes were prospectively assessed by the Sinonasal Outcomes Test-22 (SNOT-22) and endoscopic polyp grading system. Data were collected preoperatively, 1 and 4 weeks postsurgery (before desensitization), and 1, 6, 12, 18, 24, and 30 months after aspirin desensitization.
  
  
  RESULTS
  Twenty-eight of 30 patients (93.3%) successfully completed aspirin desensitization, whereas 2 of 30 (6.7%) were unable to complete desensitization due to respiratory intolerance. Of the 21 patients who successfully completed a minimum of 24 weeks of follow-up, 20 (95.2%) patients demonstrated sustained endoscopic and symptomatic improvement for a median follow-up period of 33 months. After surgical treatment but before desensitization, patients experienced significant reductions in SNOT-22 and polyp grade scores. In the first 6 months after aspirin desensitization, patients experienced further significant reductions in SNOT-22 scores, whereas polyp grade remained stable. The improvements in symptom endoscopic scores were preserved throughout the follow-up period after desensitization. No patients required additional sinus surgery. One patient had to discontinue aspirin therapy due to gastrointestinal side effects. No other adverse reactions to aspirin were noted.
  
  
  CONCLUSIONS
  Aspirin desensitization following ESS appears to be a well-tolerated and effective adjunctive therapy for long-term control of nasal polyposis in patients with AERD.
authors.affiliation: Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Kyu-Sup
authors.initials: KS
authors.lastname: Cho
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Soudry
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Alkis J
authors.initials: AJ
authors.lastname: Psaltis
authors.affiliation: Department of Pediatrics, Division of Immunology and Allergy, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Kari C
authors.initials: KC
authors.lastname: Nadeau
authors.affiliation: Department of Pediatrics, Division of Immunology and Allergy, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Sean A
authors.initials: SA
authors.lastname: McGhee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Jayakar V
authors.initials: JV
authors.lastname: Nayak
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA phwang@ohns.stanford.edu.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects; D055963:Asthma, Aspirin-Induced / Q000150:complications / Q000473:pathology / Q000628:therapy*; D003888:Desensitization, Immunologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012852:Sinusitis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin
keywords: aspirin exacerbated respiratory disease; asthma; desensitization; endoscopic sinus surgery; nasal polyps; sinusitis