Evaluation of Aspirin Hypersensitivity in Chronic Rhinosinusitis Patients

Background and Objectives�FAspirin-exacerbated respiratory disease (AERD) is a clinical tetrad of nasal polyps, chronic hypertrophic eosinophilic sinusitis, asthma, and sensitivity to aspirin. Aspirin provocation test is the gold standard for diagnosing AERD. The aim of this study was to evaluate the clinical features and prognosis after surgical treatment in chronic rhinosinusitis (CRS) patients who have aspirin hypersensitivity.

Subjects and Method�FWe conducted an analysis of 100 CRS patients who underwent endoscopic sinus surgery at the Department of Otorhinolaryngology of our hospital from October 2012 to March 2013. We measured nasal volume change and symptom change before and after the aspirin nasal provocation test (ANPT), and examined patient’s asthma history, allergy, Lund-Mackay score (LMS), total immunoglobulin E, peripheral eosinophil percentage, and objective measurement relapse.

Results�FChronic rhinosinusitis patients with nasal polyps (CRSwNP) were more likely to have a positive ANPT test results compared to patients without nasal polyps (CRSsNP) (21.4% vs. 5.5%). ANPT (+) group had higher LMS and required more revision endoscopic sinus surgery than ANPT (-) group. These results were similar to those of CRSwNP compared with CRSsNP.

Conclusion�F LMS and recurrence rates were higher in ANPT (+) compared to ANPT (-). Especially, recurrence rates were higher in ANPT (+) regardless of nasal polyp. Thus, careful endoscopic examination is required at follow up if CRS patients showed positive ANPT results.