Naples James G, Corr Andrew, Tripathi Siddhant, Berman Morgan, Brant Jason A, Ruckenstein Michael J, Bosso John
Beth Israel Deaconess Medical Center, Harvard Medical School, Division of Otolaryngology-Head and Neck Surgery, Otology/Neurotology, 110 Francis St, Suite 6E, Boston, MA 02215, USA.
University of Pennsylvania Health System, Department of Otorhinolaryngology-Head and Neck Surgery, Otology/Neurotology, 3400 Spruce St, 5 Silverstein, Philadelphia, PA 19104, USA.
World J Otorhinolaryngol Head Neck Surg. 2020 Oct 17;6(4):248-254. doi: 10.1016/j.wjorl.2020.07.006. eCollection 2020 Dec.
There are few studies evaluating the impact of Aspirin-exacerbated respiratory disease (AERD) treatment on otologic symptoms. The aim of this study is to evaluate the effects of endoscopic sinus surgery (ESS) and aspirin desensitization (AD) on otologic symptoms in subjects with AERD.
Retrospective chart review of adult patients diagnosed with AERD at our tertiary Care Academic Medical Center - Otorhinolaryngology Department. Charts of adult patients diagnosed with AERD who underwent ESS and ASA desensitization at our institution's AERD Center from 2016 to 2019 were reviewed. Sino-Nasal Outcomes Test 22-item survey (SNOT-22) scores were evaluated for patients at various time points including: pre-surgery, post-surgery/pre-aspirin desensitization, and various times post-desensitization up to >12 months. Within the SNOT-22, otologic-specific subdomain scores were evaluated at similar time points. Patients on immunomodulatory medications other than corticosteroids were excluded from analysis.
SNOT-22 scores were analyzed for 121 patients. There was a significant improvement in overall SNOT scores from pre-surgery (44.62) to post surgery/pre-desensitization (23.34) ( < 0.0005). Similarly, SNOT-22 otologic-specific scores also improved after surgery prior to desensitization (3.19-2.04) ( = 0.005). Following AD, the improvement in the overall SNOT-22 continued to improve for up to 12 months ( < 0.005). While the otologic-specific SNOT-22 scores remained stable after surgery and ASA desensitization.
ESS and AD reduce otologic-specific SNOT-22 scores and parallel trends in overall SNOT-22 scores. The effect of treatment is durable over the course of 12 months. Future work should aim to correlate otologic SNOT-22 scores with objective otologic data.
评估阿司匹林诱发的呼吸道疾病(AERD)治疗对耳科症状的影响的研究较少。本研究的目的是评估内镜鼻窦手术(ESS)和阿司匹林脱敏(AD)对AERD患者耳科症状的影响。
对在我们的三级医疗学术医学中心耳鼻喉科诊断为AERD的成年患者进行回顾性病历审查。回顾了2016年至2019年在我们机构的AERD中心接受ESS和ASA脱敏治疗的成年AERD患者的病历。对患者在不同时间点进行了鼻窦结局测试22项调查(SNOT-22)评分评估,这些时间点包括:术前、术后/阿司匹林脱敏前,以及脱敏后长达12个月以上的不同时间。在SNOT-22中,在类似时间点评估耳科特定子域评分。排除使用除皮质类固醇以外的免疫调节药物的患者进行分析。
对121例患者的SNOT-22评分进行了分析。从术前(44.62)到术后/脱敏前(23.34),总体SNOT评分有显著改善(P<0.0005)。同样,在脱敏前手术后,SNOT-22耳科特定评分也有所改善(3.19-2.04)(P=0.005)。在AD之后,总体SNOT-22的改善持续长达12个月(P<0.005)。而耳科特定的SNOT-22评分在手术和ASA脱敏后保持稳定。
ESS和AD降低了耳科特定的SNOT-22评分以及总体SNOT-22评分的平行趋势。治疗效果在12个月的过程中是持久的。未来的工作应旨在将耳科SNOT-22评分与客观耳科数据相关联。