scholarly journals Endoscopic sinus surgery improves aspirin treatment response in aspirin‐exacerbated respiratory disease patients

2019 ◽  
Vol 9 (12) ◽  
pp. 1401-1408 ◽  
Author(s):  
Sharan J. Shah ◽  
Waleed M. Abuzeid ◽  
Anusha Ponduri ◽  
Teresa Pelletier ◽  
Zhen Ren ◽  
...  
Keyword(s):  
Treatment Response ◽  
Respiratory Disease ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Aspirin Exacerbated Respiratory Disease

scholarly journals Effectiveness of endoscopic sinus surgery and aspirin therapy in the management of aspirin-exacerbated respiratory disease

2021 ◽  
Vol 42 (2) ◽  
pp. 136-141
Author(s):  
Auddie M. Sweis ◽  
Tran B. Locke ◽  
Kevin I. Ig-Izevbekhai ◽  
Theodore C. Lin ◽  
Ankur Kumar ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Endoscopic Sinus Surgery ◽  
Test Score ◽  
Aspirin Therapy ◽  
Sinus Surgery ◽  
Secondary Outcome ◽  
Persistent Symptoms ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Patient Reported ◽  
The Mean

Background: Aspirin therapy and/or type 2 (T2) biologics are used in the management of aspirin-exacerbated respiratory disease (AERD). Objective: To identify the number of patients with AERD who tolerated aspirin therapy, yet due to persistent symptoms, incorporated T2 biologic management. Methods: A retrospective review was performed between July 2016 and June 2019. Patients with AERD and who underwent endoscopic sinus surgery (ESS), aspirin desensitization (AD), and at least 6 months of aspirin therapy (ATAD) after AD, and who remained biologic-naive up through this timepoint were included in the study. Introduction of a T2 biologic while on ATAD was the primary outcome. The secondary outcome was a change in a validated patient-reported outcome measure for chronic rhinosinusitis score between the postoperative predesensitization timepoint, and the 6-month postdesensitization timepoint, presented as means and compared by using the Student's t-test. Results: A total of 103 patients met inclusion criteria. Two patients (1.9%) ultimately supplemented ATAD with a T2 biologic. The mean outcomes measure test score after 6 months of ATAD for patients who received biologics was 40.5 versus 15 in those who did not receive biologics (p = 0.02). The mean differences between the postoperative predesensitization test score and the 6-month postdesensitization test score for patients who went on to receive biologics was an increase of 13 versus a decrease of 10 for those patients who did not receive biologics (p = 0.12). Conclusion: ESS, coupled with AD and ATAD, was successful in the long-term management of the majority of the patients with AERD, which rarely required the incorporation of T2 biologics. Patient questionnaires, such as outcomes measure test score, may identify aspirin therapy failures and help guide the practitioner in deciding when to introduce T2 biologics into the patient's treatment regimen.

Allergic Rhinitis and Aspirin-Exacerbated Respiratory Disease as Predictors of the Olfactory Outcome after Endoscopic Sinus Surgery

2009 ◽  
Vol 23 (3) ◽  
pp. 348-353 ◽  
Author(s):  
Michael Katotomichelakis ◽  
Maria Riga ◽  
Spyridon Davris ◽  
Gregorios Tripsianis ◽  
Maria Simopoulou ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Disease ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Olfactory Acuity ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Negative Effect ◽  
Time Frames

Background Unlike the functional outcomes of endoscopic sinus surgery, which have been thoroughly studied, the effect of the surgery on olfactory performance and the relative predictive factors have not been adequately assessed by literature. Allergic rhinitis and aspirin-exacerbated respiratory disease (AERD) are examined as potential confounding factors of the olfactory outcome in patients with extensive nasal polyposis and rhinosinusitis treated with functional endoscopic sinus surgery (FESS). Methods A population of 116 adults with severe nasal polyposis was subjected to FESS after failure of the appropriate medical treatment. The olfactory outcome was quantified by Sniffin’ Sticks at the 1st, 3rd, and 6th postoperative month in relation to the concomitant presence of allergic rhinitis (n = 62) or AERD (n = 18). Results Allergic patients seemed to perform worse than nonallergic patients at all time frames. However, when patients with similar olfactory acuity, age, and medical history are compared, allergic rhinitis does not seem to affect the postoperative improvement of the composite threshold-discrimination-identification scores. The same seems to apply for the likelihood of acquiring normosmia after surgery. On the contrary, AERD significantly limits the recovery of olfactory function at all follow-up examinations and patients with AERD are unlikely to become normosmic. Conclusion The olfactory recovery after FESS for nasal polyposis is significantly affected by the concomitant presence of AERD. Although allergy seems to have a general negative effect on olfactory acuity, it was not found to affect the extent of the olfactory improvement, when patients with comparable preoperative characteristics are addressed.

Outcomes after complete endoscopic sinus surgery and aspirin desensitization in aspirin-exacerbated respiratory disease

2017 ◽  
Vol 8 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Nithin D. Adappa ◽  
Viran J. Ranasinghe ◽  
Michal Trope ◽  
Steven G. Brooks ◽  
Jordan T. Glicksman ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Aspirin Desensitization ◽  
Aspirin Exacerbated Respiratory Disease

Adult-onset Woakes’ syndrome: a rare entity

2021 ◽  
Vol 14 (1) ◽  
pp. e236894
Author(s):  
Pedro Salvador ◽  
Francisco Moreira da Silva ◽  
Rui Fonseca
Keyword(s):  
Ct Scan ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Nasal Dorsum ◽  
Rare Entity ◽  
Adult Onset ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Nasal Pyramid ◽  
Recurrent Nasal Polyposis

Woakes’ syndrome (WS) is a rare entity, defined as severe recalcitrant nasal polyposis with consecutive deformity of the nasal pyramid. WS occurs mainly in childhood and its aetiology remains unclear. We report a case of a 68-year old woman, with aspirin-exacerbated respiratory disease, who presented with recurrent nasal polyposis and progressive broadening of the nasal dorsum. CT scan revealed extensive bilateral nasal polyposis and diffuse osteitis, with anterior ethmoidal calcified lesions. The patient underwent revision endoscopic sinus surgery and nasal pyramid deformity was successfully managed without osteotomies.

Treatment Outcomes in Aspirin-Exacerbated Respiratory Disease Based on the 12-Item Short Form Survey

2021 ◽  
pp. 194589242110016
Author(s):  
Tran B. Locke ◽  
Auddie M. Sweis ◽  
Jennifer E. Douglas ◽  
Kevin I. Ig-Izevbekhai ◽  
Elizabeth M. Stevens ◽  
...  
Keyword(s):  
Social Functioning ◽  
Respiratory Disease ◽  
General Health ◽  
Short Form ◽  
Bodily Pain ◽  
Sinus Surgery ◽  
Role Physical ◽  
Aspirin Exacerbated Respiratory Disease ◽  
Health Domains ◽  
The Impact

Background Aspirin-exacerbated respiratory disease (AERD) is optimally managed by endoscopic sinus surgery (ESS) followed by aspirin therapy after desensitization (ATAD). Most AERD quality of life (QOL) studies use the 22-item Sinonasal Outcomes Test (SNOT-22), which focuses predominantly on sinonasal outcomes. Objective This study seeks to assess QOL outcomes in AERD patients after ESS and ATAD via the 12-item Short Form Survey (SF-12), a well-validated QOL measure for general health status of chronic conditions. Methods Retrospective review of 112 AERD patients who underwent ESS followed by ATAD at our institution between 2016 and 2019. SF-12 was collected preoperatively, postoperatively/pre-AD, and serially post-AD (1–3, 4–6, 7–12, and >12 months). Optum® PRO CoRE software was used to compare data to national norms. ANOVA was performed comparing physical component summary (PCS), mental component summary (MCS) and eight health domains (physical functioning, role physical, general health, bodily pain, vitality, social functioning, role emotional, and mental health). Results AERD patients showed improvement in PCS scores across all timepoints after ESS and ATAD (p = 0.004). When stratified by gender, women demonstrated an improvement in PCS scores (p = 0.004). Within the domains, there were significant improvements in social functioning (SF), role physical (RP), and bodily pain (BP) at all timepoints (SF: p = 0.006; RP: p = 0.005; BP: p < 0.001). Conclusions AERD patients undergoing ESS and ATAD show improvement in physical QOL and 3 of the 8 health domains as measured by the SF-12. Future studies can use the SF-12 to study the impact of AERD treatment versus other chronic diseases and health demographics.

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