Long-Term Outcome of Endoscopic Sinus Surgery in Patients with Aspirin-Exacerbated Respiratory Disease / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Patients with aspirin-exacerbated respiratory disease (AERD) tend to have more severe clinical course and also tend to be recalcitrant to conventional medical and surgical treatment. This study aimed to assess the long-term outcome of endoscopic sinus surgery in AERD patients. SUBJECTS AND METHOD: Fifteen patients with AERD (n=15) were identified through a retro-spective chart review, and compared with 74 patients of CRSwNP (with asthma n=23; without asthma n=51) by analyzing preoperative and postoperative symptoms, endoscopic score, Lund-Mackay CT score, number of revision surgery or outpatient procedures, frequency of clinic visits and medications. The CRS control status was evaluated according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2012 criteria and logistic regression analyses were conducted to investigate the determining factors of preoperative and postoperative symptoms. RESULTS: The AERD group showed higher disease severity than other groups preoperatively endoscopic score (CRSwNP s asthma 6.3±2.6 vs. CRSwNP c asthma 6.5±2.3 vs. AERD 8.8±1.4, p<0.05), CT score (12.2±4.9 vs. 17.0±4.8 vs. 18.0±2.1, p<0.05), and overall symptom score (30.8±0.4 vs. 33.8±1.5 vs. 37.9±0.7, p<0.01). The rate of revision surgery and outpatient procedures, postoperative clinic visit and prescription rate were higher in the AERD group (p<0.05, respectively). However, postoperative symptom scores and CRS control status were not significantly different among three groups (p=0.267 and p=0.996, respectively). CONCLUSION: Although AERD patients showed higher preoperative endoscopic scores and revision surgery rates, postoperative subjective symptoms were comparable to those of other groups with long-term follow up, suggesting the importance of frequent outpatient care after endoscopic sinus surgery.