Effect Of Endoscopic Sinus Surgery Research Articles

Effects of Endoscopic Sinus Surgery on Olfactory Bulb Volume among Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.

Endoscopic sinus surgery (ESS) could significantly improve olfactory function among patients with chronic rhinosinusitis (CRS). This study aimed to perform a meta-analysis to evaluate the effect of ESS on the olfactory bulb volume (OBV) among patients with CRS. A systemic search of PubMed, Medline, Embase, Web of Science, and other databases was conducted to identify studies assessing OBV changes in patients with CRS after ESS utilizing magnetic resonance imaging. A total of four studies with 168 participants were included. Comparing the changes in OBV of patients with CRS before and after surgery within 3-6 months, the ESS significantly improved the overall OBV (P = 0.005, I2 = 66%), with the left OBV increased by 5.57mm3 (P = 0.84, I2 = 0%), and the right OBV increased by 8.63mm3 (P = 0.09, I2 = 53%). A difference in OBV persists between healthy controls and patients with CRS 3-6 months after ESS. The overall OBV of patients with CRS after ESS was significantly smaller than controls (mean difference = -3.84, P = 0.04), with a mean difference of 4.13mm3 on the left side (P = 0.72, I2 = 0%), and a mean difference of 3.22mm3 on the right side (P = 0.0001, I2 = 89%). ESS significantly increases the OBV among patients with CRS.

Effectiveness of Endoscopic Sinus Surgery for Maxillary Sinusitis After Dental Implant Treatment

Effectiveness of Endoscopic Sinus Surgery for Maxillary Sinusitis After Dental Implant Treatment

IL-13 and IL-13–induced periostin levels are specifically decreased in patients following endoscopic sinus surgery for chronic rhinosinusitis

BackgroundType 2 (T2) inflammation plays a pathogenic role in chronic rhinosinusitis (CRS) effects of endoscopic sinus surgery (ESS) on T2 inflammation are unknown. ObjectiveTo compare T2 inflammatory biomarkers from middle meatal (MM) mucus for distinguishing CRS from non-CRS patients, identifying major phenotypes (CRS without (CRSsNP) and with nasal polyps (CRSwNP)), assessing endotypic change and establishing cross-sectional and longitudinal outcomes in patients undergoing ESS. MethodsMM mucus samples were collected from CRSsNP and CRSwNP patients before and 6-12 months after ESS and compared to non-CRS control patients. T2 biomarkers were evaluated continuously, using threshold-based definitions of T2 endotype, and for relationships with patient-reported (SNOT-22 and CRS-PRO) and clinician-reported (radiographic and endoscopic) severity. Linear mixed models were developed to analyze clinical variables associated with T2 biomarker levels. Results154 CRS patients (89 CRSsNP, 65 CRSwNP) were enrolled with a mean 9-month interval between ESS and follow-up. Pre-ESS MM mucus analysis revealed elevated T2 mediators in CRSwNP vs. CRSsNP and non-CRS controls. Temporally stable correlations between IL-13 and IL-5; periostin and C5a; and ECP and CCL26 was observed. On this basis and pathologic significance, IL-13, periostin and ECP were further analyzed. Post-ESS, IL-13 and periostin levels decreased significantly, ECP levels remained unchanged. Across pre- and post-ESS evaluation, the T2 endotype was associated with radiographic severity but did not predict outcomes. CRSwNP status and African American race were associated with higher levels of IL-13 and periostin, whereas ECP was higher in patients undergoing extensive surgery. ConclusionESS decreased IL-13 and periostin in MM. T2 inflammation post-ESS correlated with patient- and clinician-reported severity across phenotypes. Pre-ESS T2 inflammation did not predict post-ESS outcomes.

Effects of Endoscopic Sinus Surgery on Olfactory Function.

To review the effects of endoscopic sinus surgery and endonasal approaches to the skull base on olfaction. Advancements in endonasal endoscopic approaches to the sinuses and skull base allow for direct treatment of a variety of sinonasal and skull base diseases. However, these extended approaches will often require manipulation of normal anatomical structures and the olfactory neuroepithelium. Depending on the planned procedure and extent of disease, the prognosis of olfactory perception can vary significantly among patients. Endoscopic sinonasal surgical procedures may impact olfaction. Optimizing olfactory function requires proper surgical techniques, gentle handling of tissue, and perioperative care. Surgeons must discuss objectives and manage patient expectations. Routine olfactory assessment is crucial in surgical work-up and follow-up. Preserving anatomical structures while addressing the obstruction of the olfactory cleft helps to prevent decreased olfactory threshold. However, smell identification and discrimination do not always correlate with sinonasal anatomy.

Effect of endoscopic sinus surgery on quality of life among the patients of chronic rhinosinusitis with nasal polyposis

Abstract Background Quality of life (QoL) tests are usually used to assess the response to different therapies. They are the tools that best reflect the patients’ complaints, the severity of their pathology, and the post-therapeutic gains. The aim of the present study is to assess the effect of endoscopic sinus surgery (ESS) on quality of life (QoL) among the patients of chronic rhinosinusitis with nasal polyposis (CRSwNP), using the Sino-Nasal Outcome Test 22 items (SNOT-22). Methods This is a prospective, descriptive, and monocentric study involving all the patients who underwent surgery for CRS with nasal polyposis at Bejaia University Hospital over a period of 36 months, from January 1st, 2017, to December 31st, 2019. A SNOT-22 test was completed item by item with our patients, before any surgery, and after endoscopic sinus surgery at 1 month, 3 months, 6 months, 9 months, and 12 months. Results Sixty-five patients, having undergone ESS for CRS with nasal polyposis, were followed during a period 12 months. The average age of our patients was 42.06 ± 12.47 years, with 41.5% females and 58.5% males. Clinical examination showed that impairment was bilateral in 100% of our patients, while the nasal endoscopy showed that the polyps reached stage III in 87.7% of the cases on the right and 80% on the left. The mean Lund-Mackay CT score was 18.71 ± 4.77/24. All of the patients were treated with local and general short courses of corticosteroid therapy before ESS was indicated. Our results showed improvement in the QoL of our patients and maintenance of this gain after surgery. The average total SNOT-22 score for them was 49.41 ± 17.12 pre-operatively; post-operatively it was 12.14 ± 10.22 after 1 month; 10.31 ± 8.17 after 3 months; 9.35 ± 8.93 after 6 months; 12.21 ± 15.45 after 9 months and 12.63 ± 16.23 after 12 months. Conclusion ESS is the gold standard in the treatment of chronic rhinosinusitis with nasal polyposis after failure of medical therapy. The use of SNOT-22 test enabled us to confirm that whatever the surgical procedure applied, the QoL improves after surgery.

Relation between anterior ethmoidal artery course on computed tomography and supraorbital ethmoid cell and Keros classification.

The anterior ethmoidal artery (AEA) is an important risk area in endoscopic sinus surgery. This study aimed to evaluate the course of AEA according to the Keros classification and the presence of supraorbital ethmoid cell (SOEC) and to prevent possible complications by emphasizing the importance of preoperative paranasal computed tomography (CT) imaging. This approach will increase the effectiveness of endoscopic sinus surgery and improve patient safety. The paranasal CT scan images of patients aged > 18 years between October 2020 and November 2021 from our center were retrospectively analyzed. The images were primarily evaluated in the coronal plane, and the sagittal and axial planes were utilized to evaluate variations in AEA regarding the skull base. Furthermore, the relation of AEA course with Keros classification and SOEC was evaluated. The study included 1000 patients aged 18-80 years (right and left, a total of 2000 samples). Grade 3 AEA was the most common regarding the skull base. Keros Type 2 was the most common classification. Overall, 48.7% patients had SOEC. The incidence of Grade 3 AEA was higher among patients with SOEC and a higher Keros classification compared with those without SOEC and a lower Keros classification. Furthermore, Keros Type 3 was the most associated with SOEC presence. Consistent with the literature, the probability of Grade 3 AEA in patients with high Keros classification and SOEC was significantly higher in our study. Therefore, we consider that preoperative imaging according to Keros classification and SOEC presence can predict AEA course and guide surgery.

Maintained effect of endoscopic sinus surgery in asthma responders to drugs targeting the IL5 pathway with persistent nasal polyposis.

Maintained effect of endoscopic sinus surgery in asthma responders to drugs targeting the IL5 pathway with persistent nasal polyposis.

Retracted: Effects of Endoscopic Sinus Surgery Combined with Budesonide Treatment on Nasal Cavity Function and Serum Inflammatory Factors in Patients with Chronic Sinusitis.

[This retracts the article DOI: 10.1155/2022/4140682.].

Outcomes of Endoscopic Sinus Surgery for Chronic Rhinosinusitis in Adults with Primary Ciliary Dyskinesia.

Introduction Primary ciliary dyskinesia (PCD) is a rare inherited disease associated with impairment of mucociliary transport and, consequently, with a high incidence of chronic rhinosinusitis. For patients with chronic rhinosinusitis who remain symptomatic despite medical treatment, endoscopic sinus surgery is a safe and effective therapeutic option. However, to date, no studies have been found evaluating the effect of surgery on the quality of life associated with the effect on olfaction and nasal endoscopy findings of patients with primary ciliary dyskinesia and chronic rhinosinusitis. Objective To describe the effect of endoscopic sinus surgery on the quality of life, on olfaction, and on nasal endoscopy findings of adults with PCD and chronic rhinosinusitis. Methods Four patients who underwent endoscopic sinus surgery were included. The Sinonasal Outcome Test-22 (SNOT-22) score, the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, and the Lund-Kennedy score were collected preoperatively and at 3 and 6 months postoperatively. The olfaction as assessed with the University of Pennsylvania Smell Identification Test (UPSIT), which was administered preoperatively and 3 months postoperatively. Results A total of 4 patients with a mean age of 39.3 years old (3 men and 1 woman) completed the study. All patients showed clinically significant improvement in the SNOT-22, NOSE, and Lund-Kennedy scores at 3 months postoperatively, and this improvement was sustained throughout the follow-up period. However, olfaction did not improve after surgery. Conclusion The endoscopic sinus surgery treatment of chronic rhinosinusitis in adults with PCD was associated with improvement in quality of life and endoscopic findings. However, no improvement in olfaction was demonstrated. Studies with a larger number of patients and control groups should help confirm these findings.

Therapeutic Effects of Endoscopic Sinus Surgery in Eosinophilic Sinusitis Patients with Severe Headache

Conclusion: ESS led to a significant improvement in all symptoms in ECRS cases. Severe headache is known to interfere with daily life in ECRS patients. We speculated that patients with severe headache.

Systematic review and meta-analysis of the curative effects and safety of endoscopic sinus surgery in children with chronic sinusitis with nasal polyps.

BackgroundAt present, the surgical treatment of sinusitis with nasal polyps has made great progress, but its recurrence rate is still high. Therefore, this time, meta-analysis is used to study the therapeutic effect of endoscopic sinus surgery on children with chronic sinusitis with nasal polyps, analyze its effectiveness and safety, and provide theoretical basis for clinical treatment.MethodsBoolean logic searching was adopted to retrieve articles from various databases, including PubMed, Medline, and Chinese National Knowledge Infrastructure (CNKI), published from the establishment of the database to December 30, 2021. The following search terms were used: “endoscopic sinus surgery”, “antrochoanal polyps”, “chronic sinusitis with nasal polyps”, and “nasal polyps”. Comparative studies on traditional surgical treatment and endoscopic sinus surgery were also screened out. Review Manager was utilized for meta-analysis.ResultsA total of 9 references were included in the study, and most of them were low risk bias (medium and high quality). Meta-analysis showed that there was no statistical heterogeneity between the control group and the experimental group (Chi2=0.03, I2=0%, P=0.98). According to the fixed effect model analysis, the number of patients with polyp formation in the experimental group was significantly less than that in the control group (Z=2.65, P=0.008). Compared with the control group, there is no statistical heterogeneity in the postoperative recurrence (Chi2=1.59, I2=0%, P=0.45). According to the analysis of fixed effect model, the postoperative recurrence in the experimental group is significantly less than that in the control group (Z=2.92, OR =2.78, 95% CI: 1.40–5.52, P=0.004). Compared with the control group, the results of postoperative visual analogue scale (VAS) were statistically different (Chi2=12.63, I2=84%, P=0.002). According to the random effect model analysis, the VAS score of the experimental group was significantly lower than that of the control group (Z=18.06, MD =4.51, 95% CI: 3.96–5.05, P<0.00001).DiscussionEndoscopic sinus surgery could reduce the postoperative recurrence and pain of patients, and showed high curative effects and safety in the treatment of children with chronic sinusitis with nasal polyps.

Clinical outcomes of Eustachian tube dysfunction in chronic rhinosinusitis following endoscopic sinus surgery.

The effects of endoscopic sinus surgery (ESS) on the symptom burden of Eustachian tube dysfunction (ETD) in chronic rhinosinusitis (CRS) patients were investigated. Ninety-two patients with CRS following ESS were prospectively enrolled and followed up every 3 months for 1 year. The 7-item ETD Questionnaire (ETDQ-7) and 22-item Sino-Nasal Outcome Test (SNOT-22) were administered before ESS and at each visit following ESS. Before surgery, 25% of patients reported ETDQ-7 scores ≥ 14.5, indicating the presence of ETD. The mean preoperative ETDQ-7 and SNOT-22 scores were 13.3 and 40.0, respectively. The mean ETDQ-7 and SNOT-22 scores were significantly decreased to 8.2 and 17.0 at 1 year following ESS, respectively. Most patients reported alleviation of their symptoms within the first 3 months, and the prevalence of ETD had decreased to 3.3% at 1 year. Patients who received revision surgery had higher ETDQ-7 scores during the follow-up period. Additionally, 5.4% of patients reported worsening of their symptoms. ETD symptoms can be effectively alleviated in most patients within 3 months following ESS. However, 5.4% of patients reported worsening of their symptoms at the 1-year follow-up. Additional objective studies should be conducted to evaluate Eustachian tube function thoroughly in CRS patients.

Effects of Endoscopic Sinus Surgery Combined with Budesonide Treatment on Nasal Cavity Function and Serum Inflammatory Factors in Patients with Chronic Sinusitis.

In this article, we have explored the effects of endoscopic sinus surgery together with budesonide treatment on nasal function and serum inflammatory factors on patients with chronic sinusitis. We retrospectively analyzed 120 patients with chronic sinusitis who were admitted to our hospital from March 2018 to March 2021 and were eligible for this study. They were separated into 2 groups according to different treatments, that is, the control group (treated with endoscopic surgery alone) of 58 cases and observation group (treated with endoscopic sinus surgery combined with budesonide) with 62 cases. Treatment efficacy, surgical status, overall symptom score before and after treatment, nasal mucociliary clearance function, serum eosinophils (EOS), serum immunoglobulin E (IgE), serum inflammatory factors, and occurrence of adverse reactions of both groups were recorded and compared. Total effective rate in the observation group presented strikingly more positive compared with that among patients in control group (P<0.05), as well as the data recorded in terms of operation time, blood loss during surgery and postoperative improvement time of patients (P<0.05). Overall symptom score, nasal mucociliary clearance, EOS, IgE and serum inflammatory factors in both groups were improved notably after treatment, while the observation group held a more obvious improvement. And it also had a markedly lower incidence of adverse reaction (P<0.05). Endoscopic sinus surgery combined with budesonide in the treatment of chronic sinusitis could effectively improve the clinical symptoms of patients, reestablish the function of the nasal cavity and improve their inflammation level. Meanwhile, it was of high safety and is worthy of clinical promotion.

A prospective pilot study on the effects of endoscopic sinus surgery on upper and lower airway performance.

SUMMARYObjectiveThe relationship between chronic rhinosinusitis, asthma and allergic rhinitis is well known, but only recently has the scientific community started to evaluate these as different manifestations of a common pathogenic phenomenon, considering them as a unified airway disease.MethodsTwenty-two patients with chronic rhinosinusitis treated with endoscopic sinus surgery (ESS) were included in the study. Sino-nasal assessment questionnaire (SNAQ) investigating subjective evaluation of sino-nasal state was administered to patients, while objective evaluations included nasal endoscopy, sinonasal CT, skin prick tests, nasal cytology, spirometry, bronchodilator responsiveness testing and sputum eosinophil count. All tests were performed before surgery. Two months after surgery, SNAQ questionnaire, nasal endoscopy, spirometry and bronchodilator responsiveness testing were repeated.ResultsAll patients had significant improvement of subjective status: mean SNAQ score decreased in all from 99.31 to 16.04. Mean Forced Expiratory Volume in the 1st second (FEV1) significantly improved after surgery from 3.23 to 3.45 L/s.ConclusionsESS achieved a beneficial effect on upper and lower airway status in patients with chronic rhinosinusitis with or without lower airway diseases.

Endoscopic sinus surgery improves Eustachian tube function in patients with chronic rhinosinusitis: a multicenter prospective study

Patients with chronic rhinosinusitis (CRS) often have Eustachian tube dysfunction (ETD) symptoms. This study aimed to prospectively investigate the effect of endoscopic sinus surgery (ESS) on improvement of Eustachian tube function in CRS patients with ETD from a Chinese population and determine factors associated with improvement. A prospective study was performed in CRS patients with ETD who underwent ESS from 3 tertiary medical centers in south China. The Eustachian tube Dysfunction Questionnaire 7 (ETDQ-7), Sinonasal Outcome Test 22 (SNOT-22), tympanograms, endoscopic findings and Valsalva maneuver were recorded and analyzed preoperatively and postoperatively at 8-12 weeks. A total of 70 CRS patients with ETD were included in this study. The ETDQ-7 score and the ability of positive Valsalva maneuver in CRS patients were significantly improved postoperatively at 8-12 weeks. The number of patients with type A tympanogram was increased postoperatively. Reduced Eustachian tube mucosal inflammation was also observed postoperatively. In addition, ESS appeared to reverse slight tympanic membrane atelectasis after 8-12 weeks. Moreover, improvement in tympanogram was presented in more than half of CRS patients with concomitant otitis media with effusion postoperatively at 8-12 weeks. Univariate and multivariate analysis revealed failure of normalization of ETDQ-7 postoperatively was associated with concomitant allergic rhinitis and higher preoperative SNOT-22 score. This study confirms Eustachian tube function is often improved after ESS in CRS patients with ETD. Concomitant allergic rhinitis and higher preoperative SNOT-22 score are associated with failure of normalization of ETD symptoms.

Effect of Endoscopic Sinus Surgery on Eustachian Tube Function in Adult Sinusitis Patients: A Prospective Case-Control Study.

The eustachian tube (E-tube) function is known to be related with sinusitis; however, the effect of endoscopic sinus surgery (ESS) on E-tube function is not clearly documented. This study aimed to prospectively evaluate the function of the E-tube by using both subjective and objective tests in adult chronic sinusitis patients undergoing ESS, and to compare with those of the patients without sinusitis. Thirty adult patients who underwent ESS for treatment of chronic sinusitis and another thirty patients without sinusitis who underwent other nasal surgeries (septoplasty, rhinoplasty, or closed reduction) were evaluated and compared for E-tube function before and after three months of their surgeries. The E-tube function tests included the seven-item eustachian tube dysfunction questionnaire (ETDQ-7), Valsalva test, and inflation-deflation test that were compared preoperatively and postoperatively in both groups. Compared with the group without sinusitis, the ESS group showed significant improvement of E-tube function after surgery in the ETDQ-7 (p = 0.002), right Valsalva test (p = 0.015), right deflation test (p = 0.005), and left deflation test (p = 0.006). A binary logistic regression analysis revealed that ESS significantly improved E-tube function in the right Valsalva test in a univariate (p = 0.021) and multivariate analysis (p = 0.008), and E-tube function in the left deflation test in a univariate (p = 0.021) and multivariate analysis (p = 0.039). These findings indicate that E-tube function is significantly improved after ESS in adult sinusitis patients, and that the presence of sinusitis and implementation of ESS should be considered (if sinusitis is present) in managing patients with ear diseases that are affected by E-tube function.

Effects of Endoscopic Sinus Surgery for Eosinophilic Chronic Rhinosinusitis on Respiratory Functions and FeNO Production in the Lower Respiratory Tract.

To confirm the relevance of upper and lower airway inflammation in eosinophilic chronic rhinosinusitis (ECRS), the effects of endoscopic sinus surgery (ESS) on lower airway functions and inflammation need to be examined in ECRS patients. Chronic rhinosinusitis patients with nasal polyps (25 non-ECRS, 28 ECRS) were enrolled. The 12 patients in the ECRS group had comorbid asthma, in contrast to none in the non-ECRS group. We divided ECRS patients into 2 groups of ECRS with and without asthma. Clinical markers, including fraction of exhaled nitric oxide (FeNO), respiratory functions, and the Asthma Control Test (ACT) questionnaire, were investigated before and after ESS. The FeNO levels in the ECRS with asthma group decreased after ESS. The mean FeNO levels in this group were 56.3 ppb before ESS and 24.9, 25.1, 25.0, and 15.5 ppb 1, 2, 3, and 4 months, respectively, after ESS. The mean forced expiratory rates in 1 second before and after ESS were 67.6% and 73.0%, respectively. The mean maximal expiratory flow rates at 50% of the vital capacity before and after ESS were 45.8% and 58.0%, respectively. Significant differences were observed in respiratory functions before and after ESS. The mean ACT scores in the ECRS with asthma group before and after ESS were 17.5 and 23.5, respectively. The ACT scores were significantly higher after than before ESS. The present results indicate that ECRS and bronchial asthma are common eosinophilic airway inflammatory diseases, and ESS for eosinophilic sinusitis may improve lower airway function.

Effects of endoscopic sinus surgery on nasal spray deposition using dye-based methods for humans and a human silicone sinonasal cavity model

ObjectiveWe have evaluated that the deposition patterns of corticosteroid nasal spray in the sinonasal cavity of both post-operated human cases, which were further compared with a computed tomography-based sinonasal airway model. MethodsFifty-one patients with chronic rhinosinusitis following an endoscopic sinus surgery were enrolled in this study. Nasal spray mometasone furoate hydrate (Nasonex®) containing 0.1% indigocarmine was applied to the patients' nasal cavities and the sinonasal cavity was observed by endoscopy and video documentation. A single plaster sinonasal model was used to quantify the sinonasal deposition of nasal sprays containing 10% red ink solution using 12 round paper strips. ResultsThe predominant areas of the spray deposition of the operated sinonasal cavities were recognized in the ethmoid sinus and the olfactory cleft in the human study. The droplets were mainly deposited in the inferior turbinate followed by the posterior part of the ethmoid sinus, the olfactory cleft, and anterior part of the ethmoid sinus in a sinonasal model. ConclusionThe corticosteroid nasal spray efficiently reached the olfactory cleft and the ethmoid sinus in post-operative conditions, which was demonstrated by post-operated human cases and a computed tomography-based sinonasal airway model.

Effect of endoscopic sinus surgery on clinical outcomes in DeltaF508 cystic fibrosis patients.

Chronic rhinosinusitis (CRS) is prevalent in the Cystic Fibrosis (CF) population. CRS exacerbations in CF are thought to contribute to pulmonary exacerbations. Literature regarding the impact of endoscopic sinus surgery (ESS) is inconclusive. This study examines rates of lung function decline and pulmonary exacerbation in CF patients who have undergone ESS. Retrospective review of medical records. Academic Hospital. 40 adult CF patients. Rate of lung function decline (% predicted Forced Expiratory Volume in 1second [ppFEV1 ]), number of pulmonary exacerbations (IV/oral antibiotic therapy±hospital admission) and total number days hospitalised 2-year postoperatively was collected. CRS patients undergoing ESS were matched to those without ESS by gender, age, and F508del genotype. Forty patients (mean age 37.4, 60% male) were reviewed. No significant difference was found between the surgical group and controls in baseline ppFEV1 (72.5% vs. 72.7%, P=.98), 2-year preoperative number of pulmonary exacerbations (3.05 vs. 1.65, P=.10), or Lund-Mackay scores (12.25 vs. 11.55, P=.71). No significant difference was found in 1-year (70.5% vs. 72.8%, P=.84) or 2-year (70.4% vs. 72.6% P=.80) postoperative ppFEV1 and 2-year postoperative pulmonary exacerbations (1.7 vs. 1.45, P=.87). A significant increase was identified in total number days hospitalised postoperatively (4.85, P=.02). In the surgical group, no significant difference was identified between preoperative and postoperative ppFEV1 , 1year (-2.51%, P=.32) and 2years after ESS (-3.10%, P=.51), postoperative rate of pulmonary exacerbations (-1.28, P=.11), or in total number days hospitalised (3.74, P=.14). In this study, ESS does not appear to significantly improve ppFEV1 or decrease the number of pulmonary exacerbations postoperatively.

Effectiveness of endoscopic sinus surgery and aspirin therapy in the management of aspirin-exacerbated respiratory disease.

Background: Aspirin therapy and/or type 2 (T2) biologics are used in the management of aspirin-exacerbated respiratory disease (AERD). Objective: To identify the number of patients with AERD who tolerated aspirin therapy, yet due to persistent symptoms, incorporated T2 biologic management. Methods: A retrospective review was performed between July 2016 and June 2019. Patients with AERD and who underwent endoscopic sinus surgery (ESS), aspirin desensitization (AD), and at least 6 months of aspirin therapy (ATAD) after AD, and who remained biologic-naive up through this timepoint were included in the study. Introduction of a T2 biologic while on ATAD was the primary outcome. The secondary outcome was a change in a validated patient-reported outcome measure for chronic rhinosinusitis score between the postoperative predesensitization timepoint, and the 6-month postdesensitization timepoint, presented as means and compared by using the Student's t-test. Results: A total of 103 patients met inclusion criteria. Two patients (1.9%) ultimately supplemented ATAD with a T2 biologic. The mean outcomes measure test score after 6 months of ATAD for patients who received biologics was 40.5 versus 15 in those who did not receive biologics (p = 0.02). The mean differences between the postoperative predesensitization test score and the 6-month postdesensitization test score for patients who went on to receive biologics was an increase of 13 versus a decrease of 10 for those patients who did not receive biologics (p = 0.12). Conclusion: ESS, coupled with AD and ATAD, was successful in the long-term management of the majority of the patients with AERD, which rarely required the incorporation of T2 biologics. Patient questionnaires, such as outcomes measure test score, may identify aspirin therapy failures and help guide the practitioner in deciding when to introduce T2 biologics into the patient's treatment regimen.