Introduction: AERD (aspirin-exacerbated respiratory disease) is a severe form of an inflammatory disease of the upper airway system. Therapy remains challenging due to a complex underlying pathophysiology. Objective: To evaluate the efficacy of postoperative antileukotriene therapy concerning recurrence of nasal polyposis in patients with AERD and to compare it with AD (aspirin desensitization) over time. Methods: In this retrospective study we analyzed AERD patients (N = 61) after functional endoscopic sinus surgery (FESS). Patients were treated at our institution postoperatively with topical mometasone (control group, N = 22), leukotriene-receptor-antagonists (montelukast [MT], N = 18) or underwent an aspirin desensitization (N = 21). Subjective parameters as assessed by SNOT (sinonasal outcome test) questionnaire and endoscopic endonasal examination (polyposis grading) were evaluated throughout a follow-up period of 6–9 and #x3e;12 (long-term) months after surgery. Results: Endoscopic endonasal examinations 6–9 months after sinus surgery showed a good disease control in all 3 groups with significant reduction in polyp grading in the AD group. After a follow-up period of more than 12 months, MT and AD patients had significantly less polyp recurrences as compared to the topical treatment group. Subjective sinonasal symptoms revealed that hyposmia and nasal obstruction were prominent factors in all 3 groups throughout the follow-up period. MT group showed significant improvement in sinonasal symptoms over time. Conclusion: Postoperative treatment with leukotriene-receptor-antagonists and aspirin desensitization both significantly reduce nasal polyp recurrence. MT has a positive effect on subjective sinonasal outcomes and patients’ quality of life over time.
Int Arch Allergy Immunol

中文翻译：

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AERD相关的鼻息肉病：术后抗白三烯疗法与阿司匹林脱敏的疗效比较。回顾性研究。

简介： AERD（阿司匹林加重性呼吸系统疾病）是上呼吸道系统炎性疾病的一种严重形式。由于复杂的基础病理生理，治疗仍然具有挑战性。目的：评估术后抗白三烯疗法对AERD患者鼻息肉复发的疗效，并将其与AD（阿司匹林脱敏）随时间的变化进行比较。方法：在这项回顾性研究中，我们分析了功能性内镜鼻窦手术（FESS）后的AERD患者（ N = 61）。术后在本院接受局部莫米松（对照组， N = 22），白三烯受体拮抗剂（孟鲁司特[MT]， N= 18）或接受阿司匹林脱敏（N = 21）。通过SNOT（鼻窦预后测试）问卷和内窥镜鼻内镜检查（息肉病分级）评估的主观参数在术后6–9和＃x3e;术后12个月（长期）进行评估。结果：鼻窦手术后6–9个月的内窥镜鼻腔检查显示，所有3组患者的疾病控制均良好，AD组的息肉分级明显降低。在超过12个月的随访期后，与局部治疗组相比，MT和AD患者的息肉复发率明显降低。主观鼻窦症状表明，在整个随访期内，低渗和鼻塞是所有3组的主要因素。MT组随着时间的推移显示鼻窦症状明显改善。结论：白三烯受体拮抗剂和阿司匹林脱敏的术后治疗均可以显着降低鼻息肉复发。MT对一段时间后的主观鼻窦预后和患者生活质量有积极影响。
Int Arch过敏免疫