Research Fellow Thomas Jefferson University Hospital Philadelphia, Pennsylvania
Patients with aspirin-exacerbated respiratory disease are managed by endoscopic sinus surgery (ESS), aspirin desensitization (AD), biologics, and topical and oral corticosteroids.
Objective: To describe the demographics and impact of treatment with ESS, AD and biologics on sinonasal outcomes in patients with AERD
Methods: This is an IRB-approved, single-institution, retrospective chart review of patients identified by EMR search for two of the three AERD criteria followed by a manual chart review to confirm diagnosis in patients seen between the years 2010 and 2021. Sinonasal outcomes were described by comparing SNOT-22 and Meltzer polyp scores one year before and after initiation of treatment.
Results: Of the 129 (N) patients in the study, 44% (57) received ESS as the primary treatment modality, while others received ESS either with AD (41, 32%) or Biologics (31,24%). All patients in the study had undergone ESS for sinonasal polyps previously at a mean interval of 101.5 days for AD and 561.5 days for the Biologics cohorts. 26% of the patients had a history of receiving allergen immunotherapy. The mean age was 47.53 years (SD-16.29), 60% of the patients were women and 56.9% were Caucasian. Mean SNOT -22 scores reduced by 46.4% (63.10 to 35.69) in the FESS cohort, 40.35 % (26.27 to 15.67) in the AD cohort and 43% (58 to 33) in the biologics cohort. Mean Meltzer polyp scores reduced by 87.88% (3.88 to 0.47), 82% (4.53 to 0.82) and 38% (1.81 to 1) in the FESS, biologic and AD cohorts respectively.
Conclusion: FESS, AD and biologics result in improved sinonasal outcomes within one year of treatment. However, biologics showed improved sinonasal outcomes without the requirement for ESS