ACI International - Journal of the WAO

¹Department of Clinical Immunology and Allergy, Medical University of Lodz, 251 Pomorska st., 92-213 Lodz, Poland
²Department of Radiology, Medical University of Lodz, 251 Pomorska st., 92-213 Lodz, Poland

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Abstract

Background: Classic aspirin triad involves intolerance of non-steroidal anti-inflammatory drugs, bronchial asthma and chronic rhinosinusitis with nasal polyps. Chronic rhi-nosinusitis underlying nasal polyposis in aspirin-hypersensitive (AH) patients is more severe, as is reflected by high recurrence of nasal polyps and requirement for paranasal surgery. The aim of the study was to assess the extent of paranasal mucosal hypertrophy in patients with nasal polyps with and without aspirin triad by computer tomography (CT). Methods/Data base: Coronal computer tomography was performed on 43 patients with nasal polyps, including 20 aspirin-hypersensitive asthmatics (aspirin triad) and 23 aspirin-tolerant (AT) patients. CT scan score was calculated for each patient according to mucosal thickening in nasal passages and paranasal sinuses. Allergic background was assessed by history, skin prick testing and total serum IgE measurement. Results: Hypertrophy of the paranasal sinuses’ mucosa was found in all patients studied. The total CT score was higher in AH asthmatics as compared to AT patients (29.95 ± 1.02 and 21.78 ± 1.29; respectively, p<0.001). The average CT scores for nasal passages, ostiomeatal complex and individual sinuses were significantly higher in AH patients. CT scores did not correlate with the presence of atopy, duration of the chronic rhinosinusitis, the number of polypectomies and total serum IgE level. Conclusions: The results of CT scan imaging demonstrated that pathological changes in paranasal sinuses are more severe in AH asthmatics as compared to AT patients with chronic rhinosinusitis and nasal polyps but without asthma.