Faculty Collaboration Database

Surgical treatment of aspirin triad sinusitis. Am J Rhinol 1997;11(4):263-70

Date

07/01/1997

Pubmed ID

9292176

DOI

10.2500/105065897781446702

Scopus ID

2-s2.0-0030881105 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

Aspirin sensitivity, asthma, and chronic sinusitis with polyposis comprises the syndrome of Aspirin Triad (AT). The sinusitis associated with this disease is often fulminate and difficult to treat. In order to evaluate the surgical treatment of chronic sinusitis of AT a 17-year retrospective study of 80 patients was performed. Friedman Class III or IV sinus CT scans were present in 73 patients (90%) preoperatively. Twenty-five patients (30.1%) had steroid-dependent asthma and an additional 40 (50%) required intermittent oral steroids for asthma control. All patients underwent bilateral sinus surgery by either a conservative or a radical approach. Patients were followed from 3 weeks to 16 years postoperatively, with an average followup of 3 years. Sixty-eight patients (85%) had significant improvement in their sinus symptoms and 67 (83%) had relief of their asthma. The eight patients (10%) who remained steroid dependent required smaller doses of steroids. Seven patients (8.8%) had nonoperative orbital complications. There was a significant incidence of revision surgery after both conservative and radical sinus procedures. We conclude that surgical treatment by either a conservative or a radical approach controlled the sinusitis in the majority of AT patients, but neither was effective in eliminating the need for subsequent sinus surgery in a significant number of patients with severe sinus disease (Classes III and IV). Control of the sinus disease has a definite beneficial effect on steroid dependency and the need for intermittent oral steroids in managing the asthma in AT. We recommend conservative surgery in the surgical treatment of these patients. AT patients also require close long-term followup with intense medical management of their chronic respiratory inflammation that appears to put them at increased risk for nonoperative complications of their severe sinusitis.

Author List

McFadden EA, Woodson BT, Fink JN, Toohill RJ

Author

B Tucker Woodson MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Administration, Oral
Adolescent
Adult
Aged
Arachidonic Acid
Aspirin
Asthma
Bronchial Spasm
Chronic Disease
Female
Follow-Up Studies
Humans
Inflammation
Male
Middle Aged
Orbital Diseases
Polyps
Recurrence
Retrospective Studies
Sinusitis
Steroids
Syndrome
Tomography, X-Ray Computed