Table 1.
Study design.
| Source | Study Design | Study population | Objective | Outcomes Measured | Surgical Technique | Aspirin desensitization protocol | Follow up (months) | Level of Evidence |
|---|---|---|---|---|---|---|---|---|
| Adappa et al. | Retrospective chart review | 32 AERD patients who underwent AD following ESS | Compare AERD cohort pre-AD versus post-AD | QoL (SNOT-22) | Complete ESS, polypectomy, wide bilateral maxillary antrostomy, total sphenoethmoidectomy, frontal sinusotomy | Prior to 2012, aspirin desensitization described by Stevenson. After 2012, modified intranasal ketorolac and aspirin challenge protocol described by Lee et al AD beginning 4–6 weeks after surgery |
30 | 3b |
| Cho et al. | Retrospective chart review | 21 AERD patients who underwent AD following ESS | Assess sinonasal outcomes after AD following ESS. | QoL (SNOT-22), endoscopic polyp score | ESS, extent of surgery determined by extent of disease. Goal was removal of all polyps and drainage of all CT thickened sinuses | Aspirin desensitization beginning with 20.25 mg increasing to 40.5, 81, 162, 325, 650. Maintenance dose 650 qAM plus 325 qhs, or 325 BID daily AD beginning 4–6 weeks after surgery |
30 | 3b |
| Fruth et al. | Prospective double-blind randomized placebo-controlled trial | 31 AERD patients with recurrent nasal polyposis and >2 prior ESS. 18 in AD group, 13 in ND group | Compare outcomes between ESS AD versus ESS ND groups. | QoL (RSDI), symptom score (nonvalidated), olfactory function (Sniffin sticks), and endoscopy scores postoperatively | No comment on extent of surgery | Aspirin desensitization beginning with 180 mg increasing to 800 mg. Maintenance dose 100 mg daily AD beginning 6 weeks after surgery |
36 | 3b |
| Havel et al. | Retrospective chart review | 89 AERD patients who underwent ESS. 56 in AD group, 33 patients in ND group | Compare outcomes between ESS AD versus ESS ND groups. | QoL (VAS), symptom score (nonvalidated), endoscopy score (Rasp polyp grading) and revision surgery rates | ESS, polypectomy, uncinectomy, anterior ethmoidectomy, exploration of posterior ethmoids according to criteria of Messerklinger technique, septoplasty when necessary | Aspirin desensitization beginning with 25 mg increasing to 50, 100, 150, 200, 300, 400 and 500 mg. Maintenance dose 500 mg daily AD beginning 4–6 weeks after surgery |
18 | 3b |
| McMains and Kountakis | Retrospective chart review | 15 AERD patients who underwent ESS. 5 in AD group, 10 in ND group | Compare outcomes between ESS AD versus ESS ND groups. | QoL (SNOT), endoscopy scores based on rhinosinusitis task force methodology, revision surgery rates | No comment on extent of surgery | Aspirin desensitization described by Stevenson. Did not specify timing of initiation of aspirin desensitization |
24 | 3b |
| Shah et al. | Prospective Cohort Study | 24 AERD patients who underwent ESS and AD who failed previous medical therapy and AD | Assess whether recent ESS improved aspirin treatment outcomes in AERD patients who initially failed AD | Rhinoconjunctivitis Quality of Life | Unilateral or bilateral maxillary antrostomy, total ethmoidectomy, sphenoidotomy, frontal sinus procedures | Aspirin desensitization beginning with 650 mg BID. After 4 weeks increased to 975 mg daily for 8 weeks. Maintenance dose of 325 mg BID AD preoperatively and beginning 3–4 weeks after surgery |
6 | 2b |