Long-term sinonasal outcomes of aspirin desensitization in aspirin exacerbated respiratory disease

Objective. This study aimed to assess sinonasal outcomes inpatients with aspirin exacerbated respiratory disease(AERD) undergoing aspirin desensitization following endoscopicsinus surgery (ESS).

Study Design. Case series with chart review.

Setting. University hospital.

Subjects and Methods. A retrospective review of sinonasaloutcomes was conducted for 30 AERD patients undergoingaspirin desensitization and maintenance therapy followingESS. Sinonasal outcomes were prospectively assessed by theSinonasal Outcomes Test-22 (SNOT-22) and endoscopicpolyp grading system. Data were collected preoperatively, 1and 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 completedaspirin desensitization, whereas 2 of 30 (6.7%) wereunable to complete desensitization due to respiratory intolerance.Of the 21 patients who successfully completed a minimumof 24 weeks of follow-up, 20 (95.2%) patientsdemonstrated sustained endoscopic and symptomaticimprovement for a median follow-up period of 33 months.After surgical treatment but before desensitization, patientsexperienced significant reductions in SNOT-22 and polypgrade scores. In the first 6 months after aspirin desensitization,patients experienced further significant reductions inSNOT-22 scores, whereas polyp grade remained stable. Theimprovements in symptom endoscopic scores were preservedthroughout the follow-up period after desensitization.No patients required additional sinus surgery. One patienthad to discontinue aspirin therapy due to gastrointestinal sideeffects. No other adverse reactions to aspirin were noted.

Conclusion. Aspirin desensitization following ESS appears tobe a well-tolerated and effective adjunctive therapy for longtermcontrol of nasal polyposis in patients with AERD.