Stellenwert der Medikation mit Leukotrien-Antagonisten bei Patienten mit rezidivierender Polyposis nasi und Analgetika-Intoleranz nach funktionell endoskopischer Nasennebenhöhlenoperation

Habermann, Nicole (2022): Stellenwert der Medikation mit Leukotrien-Antagonisten bei Patienten mit rezidivierender Polyposis nasi und Analgetika-Intoleranz nach funktionell endoskopischer Nasennebenhöhlenoperation. Dissertation, LMU München: Medizinische Fakultät

Abstract

Introduction: AERD (aspirin-exacerbated respiratory dis- ease) is a severe form of an inflammatory disease of the up- per airway system. Therapy remains challenging due to a complex underlying pathophysiology. Objective: To evalu- ate the efficacy of postoperative antileukotriene therapy concerning recurrence of nasal polyposis in patients with AERD and to compare it with AD (aspirin desensitization) over time. Methods: In this retrospective study we analyzed AERD patients (N = 61) after functional endoscopic sinus sur- gery (FESS). Patients were treated at our institution postop- eratively with topical mometasone (control group, N = 22), leukotriene-receptor-antagonists (montelukast [MT], N = 18) or underwent an aspirin desensitization (N = 21). Subjective parameters as assessed by SNOT (sinonasal outcome test) questionnaire and endoscopic endonasal examination (pol- yposis grading) were evaluated throughout a follow-up pe- riod of 6–9 and >12 (long-term) months after surgery. Re- sults: Endoscopic endonasal examinations 6–9 months after sinus surgery showed a good disease control in all 3 groups with significant reduction in polyp grading in the AD group. After a follow-up period of more than 12 months, MT and AD patients had significantly less polyp recurrences as com- pared to the topical treatment group. Subjective sinonasal symptoms revealed that hyposmia and nasal obstruction were prominent factors in all 3 groups throughout the fol- low-up period. MT group showed significant improvement in sinonasal symptoms over time. Conclusion: Postoperative treatment with leukotriene-receptor-antagonists and aspi- rin desensitization both significantly reduce nasal polyp re- currence. MT has a positive effect on subjective sinonasal outcomes and patients’ quality of life over time.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 22. Dezember 2022
• 1. Bericht­erstatter:in: Havel, Miriam