More on SNOT (how much does surgery improve SNOT scores in Samter's ?)

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One major observation is that aspirin desens seems to improve the surgery's outcome (or, at least, it looks like it maintains a good outcome for a longer time).--------------Am J Rhinol. 2006 Nov-Dec;20(6):573-6.Click here to read Links Medical and surgical considerations in patients with Samter's triad. McMains KC, Kountakis SE. Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA. BACKGROUND: The aim of this study was to report on objective and subjective outcomes of patients with Samter's triad (ST) treated with functional endoscopic sinus surgery (FESS), and correlate these results with aspirin desensitization (DS) in patients. METHODS: We performed a retrospective analysis of prospectively collected data in 15 patients requiring revision FESS after failing maximum medical therapy and prior sinus surgery for chronic rhinosinusitis in the context of ST. Five patients underwent aspirin DS and 10 patients did not (non-DS). These patients represent a subset of patients previously reported who were treated in a tertiary rhinology setting over a 3-year period (1999-2001). CT scans were graded according to the Lund-Mackay grading scale and symptom scores were assessed using the Sino-Nasal Outcome Test (SNOT-20). Endoscopy was scored according to the Rhinosinusitis Task Force methodology. All patients had a minimum 2-year follow-up. RESULTS: Preoperative CT scores were 20.1+/-1.9 for non-DS patients and 20.4+/-2.0 for DS patients (p = NS). Preoperative and postoperative SNOT-20 scores for non-DS patients were 31.8+/-3.9 and 8.8+/-1.7, respectively, as compared with 32.0 z 3.6 and 7.3 +/-1.7 for DS patients (p = NS). Preoperative and postoperative endoscopy scores for non-DS patients were 7.6+/-1.2 and 2.0+/-0.4, respectively, as compared with 7.6 +/-1.3 and 1.1+/-0.4 for DS patients (p = NS). Of DS patients, none required additional surgery whereas 8 of 10 non-DS patients required additional revision during the follow-up period (p = 0.003). CONCLUSION: Revision FESS benefits patients with ST; however, the addition of aspirin DS decreases the likelihood that patients with ST will require additional surgical intervention over a 2-year period.

[Guest guest]

I am desensed to Asprin. I take 650 mg a day now of Aspirin. If I had to have sinus surgery again(had 4) should aspirin be stopped?

More on SNOT (how much does surgery improve SNOT scores in Samter's ?)

One major observation is that aspirin desens seems to improve the surgery's outcome (or, at least, it looks like it maintains a good outcome for a longer time).

--------------

Am J Rhinol. 2006 Nov-Dec;20(6):573-6.Click here to read Links

Medical and surgical considerations in patients with Samter's triad.

McMains KC, Kountakis SE.

Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.

BACKGROUND: The aim of this study was to report on objective and subjective outcomes of patients with Samter's triad (ST) treated with functional endoscopic sinus surgery (FESS), and correlate these results with aspirin desensitization (DS) in patients.

METHODS: We performed a retrospective analysis of prospectively collected data in 15 patients requiring revision FESS after failing maximum medical therapy and prior sinus surgery for chronic rhinosinusitis in the context of ST. Five patients underwent aspirin DS and 10 patients did not (non-DS). These patients represent a subset of patients previously reported who were treated in a tertiary rhinology setting over a 3-year period (1999-2001).

CT scans were graded according to the Lund-Mackay grading scale and symptom scores were assessed using the Sino-Nasal Outcome Test (SNOT-20). Endoscopy was scored according to the Rhinosinusitis Task Force methodology. All patients had a minimum 2-year follow-up.

RESULTS: Preoperative CT scores were 20.1+/-1.9 for non-DS patients and 20.4+/-2.0 for DS patients (p = NS).

Preoperative and postoperative SNOT-20 scores for non-DS patients were 31.8+/-3.9 and 8.8+/-1.7, respectively, as compared with 32.0 z 3.6 and 7.3 +/-1.7 for DS patients (p = NS).

Preoperative and postoperative endoscopy scores for non-DS patients were 7.6+/-1.2 and 2.0+/-0.4, respectively, as compared with 7.6

+/-1.3 and 1.1+/-0.4 for DS patients (p = NS).

Of DS patients, none required additional surgery whereas 8 of 10 non-DS patients required additional revision during the follow-up period (p = 0.003).

CONCLUSION: Revision FESS benefits patients with ST; however, the addition of aspirin DS decreases the likelihood that patients with ST will require additional surgical intervention over a 2-year period.

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[Guest guest]

I don't really know, but I think it is standard and/or required

procedure to suspend all blood thinning medications before surgery,

and is therefore necessary to stop aspirin. However, the duration of

this suspension is not necessarily long enough to change the surgery

outcome, meaning that if you stopped desens for, say, 1-3 weeks, you

would probably be re-sensitized and have to re-start desens, but this

would not fundamentally change the inflammation status of your mucosa

on the long-term.

Excuse me for this question, but with 4 surgeries, what would be left

to take out ? I mean that by now you would probably already have had a

complete ethmoidectomy, ostia widening, etc. Would your surgery be

needed only because of polyp regrowth ? In that case, and since your

sinuses are wide open, doesn't irrigation with saline,

saline+steroids, saline+...etc help to control them ?

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> I am desensed to Asprin. I take 650 mg a day now of Aspirin. If I

had to have sinus surgery again(had 4) should aspirin be stopped?

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> More on SNOT (how much does surgery improve SNOT

scores in Samter's ?)

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> One major observation is that aspirin desens seems to improve the

surgery's outcome (or, at least, it looks like it maintains a good

outcome for a longer time).

> --------------

>

> Am J Rhinol. 2006 Nov-Dec;20(6):573-6.Click here to read Links

> ??? Medical and surgical considerations in patients with Samter's triad.

> ??? McMains KC, Kountakis SE.

>

> ??? Department of Otolaryngology-Head and Neck Surgery, Medical

College of Georgia, Augusta, Georgia 30912, USA.

>

> ??? BACKGROUND: The aim of this study was to report on objective and

subjective outcomes of patients with Samter's triad (ST) treated with

functional endoscopic sinus surgery (FESS), and correlate these

results with aspirin desensitization (DS) in patients.

>

> METHODS: We performed a retrospective analysis of prospectively

collected data in 15 patients requiring revision FESS after failing

maximum medical therapy and prior sinus surgery for chronic

rhinosinusitis in the context of ST. Five patients underwent aspirin

DS and 10 patients did not (non-DS). These patients represent a subset

of patients previously reported who were treated in a tertiary

rhinology setting over a 3-year period (1999-2001).

>

> CT scans were graded according to the Lund-Mackay grading scale and

symptom scores were assessed using the Sino-Nasal Outcome Test

(SNOT-20). Endoscopy was scored according to the Rhinosinusitis Task

Force methodology. All patients had a minimum 2-year follow-up.

>

> RESULTS: Preoperative CT scores were 20.1+/-1.9 for non-DS patients

and 20.4+/-2.0 for DS patients (p = NS).

>

> Preoperative and postoperative SNOT-20 scores for non-DS patients

were 31.8+/-3.9 and 8.8+/-1.7, respectively, as compared with 32.0 z

3.6 and 7.3 +/-1.7 for DS patients (p = NS).

>

> Preoperative and postoperative endoscopy scores for non-DS patients

were 7.6+/-1.2 and 2.0+/-0.4, respectively, as compared with 7.6

> +/-1.3 and 1.1+/-0.4 for DS patients (p = NS).

>

> Of DS patients, none required additional surgery whereas 8 of 10

non-DS patients required additional revision during the follow-up

period (p = 0.003).

>

> CONCLUSION: Revision FESS benefits patients with ST; however, the

addition of aspirin DS decreases the likelihood that patients with ST

will require additional surgical intervention over a 2-year period.

>