Asthma Outcomes after Endoscopic Sinus Surgery in Aspirin-Tolerant versus Aspirin-Induced Asthmatic Patients
Abstract
Background Certain diseases affect both upper and lower airways. Aspirin-induced asthma (AIA) is a clinical entity characterized by asthma, nasal polyposis, and aspirin intolerance. To understand the response of the lower airway to surgical treatment of the sinuses, we examined asthma outcomes in AIA compared with a second group of aspirin-tolerant asthmatic (ATA) patients to establish if there were any differences between the two groups after endoscopic sinus surgery (ESS). Methods A retrospective record review was performed of 91 asthmatic subjects with chronic rhinosinusitis. Forty-one subjects had AIA and 50 subjects had ATA. Subjective and objective asthma outcome parameters were used to compare between the two groups at three time points: immediately before ESS and 6 and 12 months after ESS. Results Preoperatively, AIA patients had significantly higher asthma severity (p Conclusion AIA patients usually present with more severe asthma. The asthmatic complaints of AIA and ATA patients continue to improve significantly over 6 and 12 month after ESS. Although ESS helped both groups of patients, AIA had statistically significant better results compared with ATA patients in asthma severity scores and decreased need for ICS.
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Surgery may be beneficial in patients with nasal polyps with associated asthma, aspirin-exacerbated respiratory disease, or cystic fibrosis.
“Surgery may be beneficial in patients with NP with associated asthma [228,229], AERD [230], or cystic fibrosis [231-233].”
From Position Paper on Nasal Obstruction: Evaluation and Treatment (2018) · cites this paper as [230]
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International Consensus Statement on Allergy and Rhinology: Rhinosinusitis
Orlandi, R. R., Kingdom, T. T., Hwang, P. H., Smith, T. L., Alt, J. A., Baroody, F. M., Batra, P. S., Bernal‐Sprekelsen, M., Bhattacharyya, N., Chandra, R. K., et al. (2016) · International Forum of Allergy & Rhinology · doi:10.1002/alr.21695 · Cited by 892 · see citing works
Position Paper on Nasal Obstruction: Evaluation and Treatment
SEAIC Rhinoconjunctivitis Committee & SEORL Rhinology, A., Valero, A., Navarro, A., del Cuvillo, A., Alobid, I., Benito, Jr., Colás, C., de los Santos, G., Fernández Liesa, R., García-Lliberós, A., et al. (2018) · Journal of Investigational Allergology and Clinical Immunology · doi:10.18176/jiaci.0232 · Cited by 76 · see citing works
Combined airways: impact of upper airway on lower airway
Fasano, M. B. (2010) · Current Opinion in Otolaryngology & Head & Neck Surgery · doi:10.1097/moo.0b013e328334aa0e · Cited by 38 · see citing works
Self-citation
- Authors
- Awad, O. G., Fasano, M. B., Lee, J. H., & Graham, S. M.
- Affiliations
- University of Iowa (US)
- Department of Otolaryngology-Head and Neck Surgery
- Corresponding author
- Graham, Scott M.
- Venue
- American Journal of Rhinology
- Publisher
- SAGE Publications
- Published
- 2008-03
- Volume
- 22
- Issue
- 2
- Pages
- 197-203
- ISSN
- 1050-6586 (ISSN-L)
- 1539-6290
- OpenAlex
- W2062656759
- Cited by
- 55
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 1 · 2012: 5
- FWCI
- 6.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Rhinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- aspirin-exacerbated respiratory disease, aspirin-tolerant asthma, endoscopic sinus surgery, chronic rhinosinusitis, asthma outcomes, asthma severity, inhaled corticosteroid dose reduction, nasal polyps, upper and lower airway interaction
- MeSH terms
- Adult, Anti-Inflammatory Agents, Non-Steroidal, Aspirin, Asthma, Endoscopy, Female, Humans, Male, Middle Aged, Nasal Polyps, Paranasal Sinuses, Retrospective Studies, Severity of Illness Index, Treatment Outcome
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