Sinonasal outcomes after endoscopic sinus surgery in asthmatic patients with nasal polyps: a difference between aspirin-tolerant and aspirin-induced asthma?

Osama G Awad; John H Lee; Mary Beth Fasano; Scott M Graham

doi:10.1097/MLG.0b013e318170af1e

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Sinonasal outcomes after endoscopic sinus surgery in asthmatic patients with nasal polyps: a difference between aspirin-tolerant and aspirin-induced asthma?

Journal article

Peer reviewed

Sinonasal outcomes after endoscopic sinus surgery in asthmatic patients with nasal polyps: a difference between aspirin-tolerant and aspirin-induced asthma?

Osama G Awad, John H Lee, Mary Beth Fasano and Scott M Graham

The Laryngoscope, Vol.118(7), pp.1282-1286

07/2008

DOI: 10.1097/MLG.0b013e318170af1e

PMID: 18475212

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Abstract

Aspirin-sensitivity, asthma, and nasal polyposis (NP) comprise the clinical entity of Samter's triad. The aim of this study is to report the sinonasal outcomes of endoscopic sinus surgery (ESS) in treating NP in asthmatic patients, comparing aspirin-induced asthmatic (AIA) patients with aspirin-tolerant asthmatics (ATA). Retrospective chart review. The records of 66 patients with NP and asthma were retrospectively reviewed. Forty-one AIA patients were compared with 25 ATA patients. For each patient, a Lund-Mackay computed tomography (CT) score of the preoperative scans and the available postoperative CT scans in a period of 18 months were calculated and used as primary endpoint. Sinonasal improvement assessed by patients and reported with a symptoms scale was used as the secondary endpoint for the comparison immediately before surgery and 6 months and 12 months following ESS. Preoperative CT scores in AIA patients compared with ATA patients were significantly higher 19 (standard deviation, 4.82) vs. 14 (standard deviation, 6.8), respectively (P = .006). This difference was sustained for the available postoperative CT scans (P < .0001). During the period of 18 months follow-up, 63.4% of AIA patients vs. 96% of ATA patients had CT improvement with a statistically significant difference between the two groups (P = .003). At 6 months following ESS, 63.4% of AIA patients vs. 56% of ATA patients had symptomatic improvement. At 12 months, 68.3% of AIA patients vs. 60% of ATA patients had symptomatic improvement, with no significant difference between the two groups. AIA patients had more extensive sinonasal disease than ATA patients. Both groups showed statistically significant improvement in sinonasal outcomes after ESS. The difference between the two groups was statistically significant for patients' CT improvement with worse CT scores being seen in AIA patients.

Postoperative Complications - etiology

Humans

Middle Aged

Drug Hypersensitivity - diagnostic imaging

Endoscopy - methods

Male

Nasal Polyps - surgery

Tomography, X-Ray Computed

Treatment Outcome

Asthma - diagnostic imaging

Asthma - chemically induced

Nasal Polyps - diagnostic imaging

Aspirin - adverse effects

Asthma - surgery

Adult

Female

Bleeding Time

Retrospective Studies

Drug Hypersensitivity - complications

Postoperative Complications - diagnostic imaging

Details

Title: Subtitle: Sinonasal outcomes after endoscopic sinus surgery in asthmatic patients with nasal polyps: a difference between aspirin-tolerant and aspirin-induced asthma?
Creators: Osama G Awad - Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa 52242-1091, USA
John H Lee
Mary Beth Fasano
Scott M Graham
Resource Type: Journal article
Publication Details: The Laryngoscope, Vol.118(7), pp.1282-1286
Publisher: United States
DOI: 10.1097/MLG.0b013e318170af1e
PMID: 18475212
ISSN: 0023-852X
eISSN: 1531-4995
Language: English
Date published: 07/2008
Academic Unit: Stead Family Department of Pediatrics; Rheumatology, Allergy, and Immunology; Immunology; Neurosurgery; Otolaryngology; Internal Medicine
Record Identifier: 9984006462502771

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