Objectives: To compare objective and quality of life (QOL) outcomes after endoscopic sinus surgery (ESS) in aspirin (ASA)-tolerant patients and ASA-intolerant patients over intermediate and long-term follow-up.
Study Design: Prospective analysis of a cohort of patients with chronic rhinosinusitis.
Methods: Preoperative computed tomography (CT), pre- and postoperative endoscopy, and two validated disease specific QOL instruments, the Rhinosinusitis Disability Index (RSDI) and Chronic Sinusitis Survey (CSS), were collected. Differences in the proportions of patients who improved were analyzed using Pearson's chi-square and Fisher's exact test.
Results: Nineteen ASA-intolerant patients and 104 ASA-tolerant patients were followed for a mean of 17.7 months. Patients with ASA intolerance had significantly worse preoperative CT (P < .0001) and endoscopy scores (P < .0001). After ESS, 57% to 74% of patients improved on endoscopy scores, 63% to 71% improved on the RSDI, and 58% to 73% improved on the CSS; improvement did not significantly differ by ASA status.
Conclusions: Similar proportions of ASA-tolerant and ASA-intolerant patients showed improvement on endoscopy and QOL measures after ESS.
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http://dx.doi.org/10.1097/MLG.0b013e3180333121 | DOI Listing |
Biomedicines
September 2024
Department of Gastroenterology, Kawasaki Medical School, Okayama 701-0192, Japan.
Background/objectives: 5-Aminosalicylic acid (5-ASA) is a first-line therapy for ulcerative colitis (UC). This study examined the mucosa-associated microbiota (MAM) in UC patients, distinguishing between those who were 5-ASA tolerant and intolerant.
Methods: Brushing samples were collected from the sigmoid and ileal end of patients with UC during endoscopic procedures.
Am J Rhinol Allergy
July 2018
1 Department of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, California.
Background Aspirin-exacerbated respiratory disease (AERD), also known as Samter's triad or aspirin (ASA)-intolerant asthma, affects 7% of asthmatics and has a higher prevalence in those with chronic rhinosinusitis and concomitant nasal polyposis. ASA desensitization with daily ASA therapy is a uniquely beneficial treatment for this disease entity and has been shown to have a significant impact on symptom scores, polyp disease, and need for systemic corticosteroids. However, no long-term studies have demonstrated whether or not ASA therapy remains safe and beneficial for these patients beyond 5-10 years.
View Article and Find Full Text PDFActa Otolaryngol
August 2016
a 1 Department of Neurosciences DNS, Otolaryngology Section, Padova University, Padova, Italy.
Conclusions: The preliminary finding of significantly lower eosinophilic-type CRSwNP recurrence rates in patients with associated asthma or ASA intolerance treated post-operatively with local nasal and oral steroids warrants further investigation in larger, prospective series.
Objective: A high recurrence rate after functional endoscopic sinus surgery (FESS) has been widely reported in patients with eosinophilic-type chronic rhinosinusitis with nasal polyps (CRSwNP). This study compared the influence of two post-operative medical treatments - local nasal steroids alone vs local nasal and oral steroids - on the recurrence of eosinophilic-type CRSwNP.
Duodecim
April 2012
Helsingin Yliopistollinen keskussairaala, korva-, nenä- ja kurkkutautien klinikka, HUS.
Nasal polyposis is an adult type mucosal inflammation of unknown etiology. Polyps are found in 4% of the Finns and in 17% of asthma patients. The first-line treatment is corticosteroid nasal spray and, if necessary, corticosteroid nasal drops or orally administered corticosteroids.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
June 2012
Department of Otolaryngology, Head and Neck Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55101 Mainz, Germany.
A dysregulation of the cyclooxygenases and a leukotriene/prostaglandin imbalance are assumed to be part of the pathogenesis of the aspirin (ASA) intolerance syndrome. Ozone is an air pollutant with known proinflammatory effects on exposed epithelia, however, its impact on the expression of the cyclooxygenases 1 and 2 (cox1/2) and prostaglandin E(2) (PGE(2)) in the nasal mucosa is not well known. Therefore, we analyzed cox expression and PGE(2) levels after ozone exposure in nasal mucosa and in nasal polyps considering ASA intolerance.
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