Document Detail

Medical and surgical considerations in patients with Samter's triad.
MedLine Citation:
PMID:  17181095     Owner:  NLM     Status:  MEDLINE    
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.
K Christopher McMains; Stilianos E Kountakis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of rhinology     Volume:  20     ISSN:  1050-6586     ISO Abbreviation:  Am J Rhinol     Publication Date:    2006 Nov-Dec
Date Detail:
Created Date:  2006-12-21     Completed Date:  2007-02-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807268     Medline TA:  Am J Rhinol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-6     Citation Subset:  IM    
Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.
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MeSH Terms
Aspirin / adverse effects*
Asthma / complications*
Desensitization, Immunologic / methods
Drug Hypersensitivity / complications*,  drug therapy
Follow-Up Studies
Glucocorticoids / therapeutic use
Middle Aged
Nasal Polyps / complications*,  diagnosis,  surgery
Otorhinolaryngologic Surgical Procedures / methods*
Prospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Reg. No./Substance:
0/Glucocorticoids; 50-78-2/Aspirin

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