Outcomes of modified endoscopic Lothrop in aspirin-exacerbated respiratory disease with nasal polyposis

Morrissey, David K., Bassiouni, Ahmed, Psaltis, Alkis J., Naidoo, Yuresh and Wormald, Peter-John (2016) Outcomes of modified endoscopic Lothrop in aspirin-exacerbated respiratory disease with nasal polyposis. International Forum of Allergy and Rhinology, . doi:10.1002/alr.21739

Author Morrissey, David K.
Bassiouni, Ahmed
Psaltis, Alkis J.
Naidoo, Yuresh
Wormald, Peter-John
Title Outcomes of modified endoscopic Lothrop in aspirin-exacerbated respiratory disease with nasal polyposis
Journal name International Forum of Allergy and Rhinology   Check publisher's open access policy
ISSN 2042-6984
Publication date 2016-03-14
Year available 2016
Sub-type Article (original research)
DOI 10.1002/alr.21739
Open Access Status Not Open Access
Total pages 6
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Collection year 2017
Language eng
Formatted abstract
Background: Patients with aspirin-exacerbated respiratory disease (AERD) and chronic rhinosinusitis with nasal polyps (CRSwNP) are often reported to be recalcitrant to standard medical and surgical intervention. Failure rates of standard endoscopic sinus surgery in these patients are reported to be as high as 90%. We review the outcomes for our cohort of AERD patients undergoing endoscopic sinus surgery and endoscopic modified Lothrop procedure (EMLP).

Methods: Data was collected prospectively between January 2001 and December 2013. Information including demographics, asthma status, aspirin sensitivity, 22-item Sino-Nasal Outcome Test (SNOT-22), Lund-Mackay scores, and endoscopic ostium assessment were collected for up to 5 years. Minimum follow-up was 6 months.

Results: A total of 31 AERD patients underwent complete sphenoethmoidectomy, maxillary antrostomy and EMLP during the study period with an average follow-up of 36 months. Polyp recurrence was seen in a total of 18 patients (58%). Seven patients required revision EMLP following initial surgery demonstrating a failure rate of 22.5%. AERD patients had a statistically significant increased risk of both nasal polyps recurrence and need for revision surgery. Revision EMLP was needed due to recurrence of nasal polyps in 6 cases and frontal ostium stenosis in a single case. Time to revision EMLP was similar between the groups.

Conclusion: Complete sphenoethmoidectomy, maxillary antrostomy, and EMLP is successful in a significant majority of patients with AERD and CRSwNP. It is well tolerated with a low complication rate and facilitates successful ongoing medical management of the condition in patients with AERD.
Keyword Asthma
Chronic rhinosinusitis
Endoscopic sinus surgery
Extended frontal sinusotomy
Frontal sinusotomy
Sinus surgery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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