Faculty Collaboration Database

Long-term asthma outcomes after endoscopic sinus surgery in aspirin triad patients. Am J Otolaryngol 2006;27(3):154-60

Date

05/02/2006

Pubmed ID

16647978

DOI

10.1016/j.amjoto.2005.09.001

Scopus ID

2-s2.0-33646106553 (requires institutional sign-in at Scopus site)   28 Citations

Abstract

BACKGROUND: Aspirin triad disease (ATD) is a well-known clinical entity characterized by asthma, polyposis, and aspirin intolerance. Using subjective and objective clinical data, this study examines the short- and long-term outcomes of asthma after sinus surgery in patients with ATD.

METHODS: A retrospective review and standardized survey in the setting of an academic tertiary rhinology program. Eighty-five patients with ATD who had endoscopic sinus surgery between 1986 and 1998 were identified from an internal database. Standardized surveys were sent to each patient to assess both objective and subjective improvement of their asthma.

RESULTS: The address and location of 20 of 85 patients could not be ascertained. Thirty-four of the remaining 65 patients (52.3%) with ATD who underwent endoscopic sinus surgery responded to the survey. Respondents had a mean follow-up of 10 years. Overall, 29 (94%) of 31 patients who reported asthma symptoms preoperatively noted long-term postoperative improvement. Furthermore, 21 of these 31 patients (68%) reported further improvement of their asthma beyond the first postoperative year. Emergency department visits for asthma exacerbations decreased in 17 (94%) of 18. Inpatient hospitalizations for asthma exacerbations also decreased in the first postoperative year in 10 (91%) of 11 patients. Asthma attacks declined in 12 (41%) of 27 patients the first year, whereas 24 (88.9%) of 27 patients had fewer asthma attacks in the last 12 months of follow-up. Peak flow rates improved from an average of 60% of the predicted value preoperatively to 86% at the time of follow-up.

CONCLUSIONS: The asthma component of ATD continues to improve with time after endoscopic sinus surgery. Although the most dramatic decrease occurs in the first year after sinus surgery, the majority of patients noted further improvement in subsequent years.

Author List

Loehrl TA, Ferre RM, Toohill RJ, Smith TL

Author

Todd A. Loehrl MD Professor in the Otolaryngology department at Medical College of Wisconsin

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

Aspirin
Asthma
Chronic Disease
Drug Hypersensitivity
Endoscopy
Female
Humans
Male
Nasal Polyps
Peak Expiratory Flow Rate
Retrospective Studies
Rhinitis
Sinusitis
Surveys and Questionnaires
Treatment Outcome