Severe bronchospasm and anaphylaxis are unanticipated emergencies that may occur in the ambulatory surgery setting. I present a case in which an asthmatic male with nasal congestion has anaphylaxis after induction, wi...Severe bronchospasm and anaphylaxis are unanticipated emergencies that may occur in the ambulatory surgery setting. I present a case in which an asthmatic male with nasal congestion has anaphylaxis after induction, with severe bronchospasm as the primary manifestation. During the course of hospitalization, he was exposed to aspirin and a second episode of severe bronchospasm occurred. He was diagnosed with both anaphylaxis to an anesthetic medication and Aspirin Exacerbated Respiratory Disease, or Samter’s Triad.展开更多
The current literature lacks strong guidelines regarding surgical management of patients with aspirin-exacerbated respiratory disease(AERD),who present with the clinical triad of chronic rhinosinusitis with nasal poly...The current literature lacks strong guidelines regarding surgical management of patients with aspirin-exacerbated respiratory disease(AERD),who present with the clinical triad of chronic rhinosinusitis with nasal polyposis(CRSwNP),bronchial asthma,and aspirin/nonsteroidal anti-inflammatory drug intolerance.To further define the effectiveness of sinus surgery in treating AERD patients,this review article discusses current evidence regarding outcomes associated with more extensive surgery,the benefits of frontal sinus surgery on polyposis,and the role of Draf III intervention.Numerous studies suggest that Draf III frontal sinusotomy may be an efficacious early intervention due to increased neo-ostial patency and subsequent distribution of topical therapies.Future studies that further investigate the efficacy and safety of extensive surgery in AERD patients are warranted.展开更多
Patients with aspirin exacerbated respiratory disease(AERD)experience a severe and recalcitrant form of chronic rhinosinusitis with nasal polyposis(CRSwNP)and asthma,which are exacerbated by aspirin/NSAID ingestion.As...Patients with aspirin exacerbated respiratory disease(AERD)experience a severe and recalcitrant form of chronic rhinosinusitis with nasal polyposis(CRSwNP)and asthma,which are exacerbated by aspirin/NSAID ingestion.As compared with aspirin-tolerant CRSwNP,patients with AERD experience more severe olfactory dysfunction,which is one of the key contributors to the observed decrease in quality of life(QOL)in this disease.The objective of this paper is to review the published olfactory outcomes observed with various treatment modalities.展开更多
Objective: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...Objective: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.Methods: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.Results: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)(P<0.0005).Similarly,SNOT-22 otologic-specific scores also improved after surgery prior to desensitization(3.19-2.04)(P=0.005).Following AD,the improvement in the overall SNOT-22 continued to improve for up to 12 months(P<0.005).While the otologic-specific SNOT-22 scores remained stable after surgery and ASA desensitization.Conclusion: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.展开更多
文摘Severe bronchospasm and anaphylaxis are unanticipated emergencies that may occur in the ambulatory surgery setting. I present a case in which an asthmatic male with nasal congestion has anaphylaxis after induction, with severe bronchospasm as the primary manifestation. During the course of hospitalization, he was exposed to aspirin and a second episode of severe bronchospasm occurred. He was diagnosed with both anaphylaxis to an anesthetic medication and Aspirin Exacerbated Respiratory Disease, or Samter’s Triad.
文摘The current literature lacks strong guidelines regarding surgical management of patients with aspirin-exacerbated respiratory disease(AERD),who present with the clinical triad of chronic rhinosinusitis with nasal polyposis(CRSwNP),bronchial asthma,and aspirin/nonsteroidal anti-inflammatory drug intolerance.To further define the effectiveness of sinus surgery in treating AERD patients,this review article discusses current evidence regarding outcomes associated with more extensive surgery,the benefits of frontal sinus surgery on polyposis,and the role of Draf III intervention.Numerous studies suggest that Draf III frontal sinusotomy may be an efficacious early intervention due to increased neo-ostial patency and subsequent distribution of topical therapies.Future studies that further investigate the efficacy and safety of extensive surgery in AERD patients are warranted.
文摘Patients with aspirin exacerbated respiratory disease(AERD)experience a severe and recalcitrant form of chronic rhinosinusitis with nasal polyposis(CRSwNP)and asthma,which are exacerbated by aspirin/NSAID ingestion.As compared with aspirin-tolerant CRSwNP,patients with AERD experience more severe olfactory dysfunction,which is one of the key contributors to the observed decrease in quality of life(QOL)in this disease.The objective of this paper is to review the published olfactory outcomes observed with various treatment modalities.
文摘Objective: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.Methods: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.Results: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)(P<0.0005).Similarly,SNOT-22 otologic-specific scores also improved after surgery prior to desensitization(3.19-2.04)(P=0.005).Following AD,the improvement in the overall SNOT-22 continued to improve for up to 12 months(P<0.005).While the otologic-specific SNOT-22 scores remained stable after surgery and ASA desensitization.Conclusion: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.
