title: The role of aspirin desensitization in the management of aspirin-exacerbated respiratory disease.
abstract: OBJECTIVE
  Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients.
  
  
  RESULTS
  Numerous studies, including randomized, double-blind, placebo-controlled trials, have demonstrated the therapeutic effectiveness of aspirin desensitization with significant improvement in number of sinus infections per year, olfactory scores, nasal symptom scores, asthma symptom scores, sinus operations, hospitalizations, emergency room visits, and oral steroid use. Furthermore, the role of surgery is becoming increasingly important for recalcitrant sinus disease with recent studies showing comprehensive surgery as more beneficial to disease management.
  
  
  CONCLUSIONS
  Aspirin desensitization is an effective therapeutic tool in the management of AERD. A multidisciplinary approach is critical between the otorhinolaryngologist and allergist to provide the most optimal care for this complex patient population.
authors.affiliation: aDepartment of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA bDepartment of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada cDepartment of Otorhinolaryngology - Head and Neck Surgery, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Bobby A
authors.initials: BA
authors.lastname: Tajudeen
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Schwartz
authors.forename: John V
authors.initials: JV
authors.lastname: Bosso
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D003888:Desensitization, Immunologic / Q000379:methods*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin