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

Otolaryngol Head Neck Surg. 2014 Oct;151(4):575-81. doi: 10.1177/0194599814545750. Epub 2014 Aug 12.


Objective: This study aimed to assess sinonasal outcomes in patients with aspirin exacerbated respiratory disease (AERD) undergoing aspirin desensitization following endoscopic sinus surgery (ESS).

Study design: Case series with chart review.

Setting: University hospital.

Subjects and methods: A retrospective review of sinonasal outcomes was conducted for 30 AERD patients undergoing aspirin desensitization and maintenance therapy following ESS. Sinonasal outcomes were prospectively assessed by the Sinonasal Outcomes Test-22 (SNOT-22) and endoscopic polyp grading system. Data were collected preoperatively, 1 and 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 completed aspirin desensitization, whereas 2 of 30 (6.7%) were unable to complete desensitization due to respiratory intolerance. Of the 21 patients who successfully completed a minimum of 24 weeks of follow-up, 20 (95.2%) patients demonstrated sustained endoscopic and symptomatic improvement for a median follow-up period of 33 months. After surgical treatment but before desensitization, patients experienced significant reductions in SNOT-22 and polyp grade scores. In the first 6 months after aspirin desensitization, patients experienced further significant reductions in SNOT-22 scores, whereas polyp grade remained stable. The improvements in symptom endoscopic scores were preserved throughout the follow-up period after desensitization. No patients required additional sinus surgery. One patient had to discontinue aspirin therapy due to gastrointestinal side effects. No other adverse reactions to aspirin were noted.

Conclusion: Aspirin desensitization following ESS appears to be a well-tolerated and effective adjunctive therapy for long-term control of nasal polyposis in patients with AERD.

Keywords: aspirin exacerbated respiratory disease; asthma; desensitization; endoscopic sinus surgery; nasal polyps; sinusitis.

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal* / adverse effects
  • Aspirin* / adverse effects
  • Asthma, Aspirin-Induced / complications
  • Asthma, Aspirin-Induced / pathology
  • Asthma, Aspirin-Induced / therapy*
  • Desensitization, Immunologic*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps / complications
  • Nasal Polyps / pathology
  • Nasal Polyps / surgery*
  • Retrospective Studies
  • Rhinitis / complications
  • Rhinitis / pathology
  • Rhinitis / surgery*
  • Sinusitis / complications
  • Sinusitis / pathology
  • Sinusitis / surgery*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome


  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin