Perioperative management and perceived risks of sinus surgery in patients with aspirin‐exacerbated respiratory disease

Abstract

Aspirin-exacerbated respiratory disease (AERD) patients often have recalcitrant nasal polyps requiring comprehensive endoscopic sinus surgery (ESS). Sinus surgery is associated with reduced severity of symptoms and enhanced quality of life.1 Regrowth of nasal polyps after ESS is common in AERD, and revision surgeries are often necessary to achieve long-term control.2 The need for revision ESS among AERD patients taking daily high-dose aspirin therapy after desensitization can pose a challenge, particularly given the risk of acute reactions when resuming aspirin after a break in treatment >48 hours.3 There are currently 2 perioperative protocols available for AERD patients on high-dose aspirin. One protocol proposed by Do et al involves an ibuprofen bridge,4 and the other previously unpublished protocol involves continuation of aspirin at a lower dose (Table 1). The awareness of and adherence to these protocols among surgeons is unknown. This study aimed to define the knowledge, attitudes, and practices related to perioperative management and perceived risks associated with ESS in AERD patients on high-dose aspirin therapy. PATIENTS ANDMETHODS