The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease

Background: Aspirin-exacerbated respiratory disease (AERD) is an aggressive inflammatory disorder of the upper and lower respiratory tract. Corticosteroids, leukotriene modifiers, endoscopic sinus surgery (ESS), aspirin (ASA) desensitization, and biological immunomodulators are currently used to tre...

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Autores principales:	Tran Locke, Auddie Sweis, Theodore Lin, Brian Sweis, Patrick Gleeson, Michael Kohanski, Nithin Adappa, James Palmer, John Bosso
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2020
Materias:	Psychosocial domain AERD Aspirin desensitization Sinus surgery Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/3b4a0a8076954a5193346e512872dec0
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spelling	oai:doaj.org-article:3b4a0a8076954a5193346e512872dec02021-12-02T14:22:06ZThe impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease2095-881110.1016/j.wjorl.2020.07.008https://doaj.org/article/3b4a0a8076954a5193346e512872dec02020-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881120301372https://doaj.org/toc/2095-8811Background: Aspirin-exacerbated respiratory disease (AERD) is an aggressive inflammatory disorder of the upper and lower respiratory tract. Corticosteroids, leukotriene modifiers, endoscopic sinus surgery (ESS), aspirin (ASA) desensitization, and biological immunomodulators are currently used to treat the disorder. Objective: The objective of this study was to determine the psychosocial impact of ESS and ASA desensitization on AERD patients. Methods: All AERD patients who underwent complete ESS were divided into two cohorts based on ASA desensitization status. The psychosocial metrics of the SNOT-22 were collected and analyzed at the following time points: pre-operative, 1-month, 3-month, 6-month, and 12-month after ESS. Results: One hundred and eighty-four AERD patients underwent ESS from November 2009 to November 2018. From this group, 130 patients underwent ASA desensitization (AD cohort) and 54 patients remained non-desensitized (ND cohort). AD patients showed a significantly greater reduction in total SNOT-22 scores over the study period compared to ND patients (p = 0.0446). Analysis of SNOT-22 psychosocial metrics showed a significantly greater improvement in patient productivity in the AD cohort when compared to the ND cohort (p = 0.0214). Further, a sub-group analysis accounting for subject attrition showed a significantly greater improvement in both productivity and concentration in AD patients when compared to the ND cohort (productivity: p = 0.0068; concentration: p = 0.0428). Conclusions: ESS followed by ASA desensitization decreases the overall psychosocial burden in AERD patients with a significant improvement in perceived productivity and concentration. This has significant implications given the psychosocial impact of chronic diseases.Tran LockeAuddie SweisTheodore LinBrian SweisPatrick GleesonMichael KohanskiNithin AdappaJames PalmerJohn BossoKeAi Communications Co., Ltd.articlePsychosocial domainAERDAspirin desensitizationSinus surgeryOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 6, Iss 4, Pp 214-219 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Psychosocial domain AERD Aspirin desensitization Sinus surgery Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Psychosocial domain AERD Aspirin desensitization Sinus surgery Otorhinolaryngology RF1-547 Surgery RD1-811 Tran Locke Auddie Sweis Theodore Lin Brian Sweis Patrick Gleeson Michael Kohanski Nithin Adappa James Palmer John Bosso The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
description	Background: Aspirin-exacerbated respiratory disease (AERD) is an aggressive inflammatory disorder of the upper and lower respiratory tract. Corticosteroids, leukotriene modifiers, endoscopic sinus surgery (ESS), aspirin (ASA) desensitization, and biological immunomodulators are currently used to treat the disorder. Objective: The objective of this study was to determine the psychosocial impact of ESS and ASA desensitization on AERD patients. Methods: All AERD patients who underwent complete ESS were divided into two cohorts based on ASA desensitization status. The psychosocial metrics of the SNOT-22 were collected and analyzed at the following time points: pre-operative, 1-month, 3-month, 6-month, and 12-month after ESS. Results: One hundred and eighty-four AERD patients underwent ESS from November 2009 to November 2018. From this group, 130 patients underwent ASA desensitization (AD cohort) and 54 patients remained non-desensitized (ND cohort). AD patients showed a significantly greater reduction in total SNOT-22 scores over the study period compared to ND patients (p = 0.0446). Analysis of SNOT-22 psychosocial metrics showed a significantly greater improvement in patient productivity in the AD cohort when compared to the ND cohort (p = 0.0214). Further, a sub-group analysis accounting for subject attrition showed a significantly greater improvement in both productivity and concentration in AD patients when compared to the ND cohort (productivity: p = 0.0068; concentration: p = 0.0428). Conclusions: ESS followed by ASA desensitization decreases the overall psychosocial burden in AERD patients with a significant improvement in perceived productivity and concentration. This has significant implications given the psychosocial impact of chronic diseases.
format	article
author	Tran Locke Auddie Sweis Theodore Lin Brian Sweis Patrick Gleeson Michael Kohanski Nithin Adappa James Palmer John Bosso
author_facet	Tran Locke Auddie Sweis Theodore Lin Brian Sweis Patrick Gleeson Michael Kohanski Nithin Adappa James Palmer John Bosso
author_sort	Tran Locke
title	The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
title_short	The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
title_full	The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
title_fullStr	The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
title_full_unstemmed	The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
title_sort	impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease
publisher	KeAi Communications Co., Ltd.
publishDate	2020
url	https://doaj.org/article/3b4a0a8076954a5193346e512872dec0
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The impact of endoscopic sinus surgery and aspirin desensitization on psychological burden in aspirin-exacerbated respiratory disease

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