gms | German Medical Science

77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

Long term results of the leukotriene antagonist Montelukast in controlling sinunasal polyposis in aspirin triad disease

Kontrolle der Polyposis nasi mit dem Leukotrienrezeptorantagonisten Montelukast bei Patienten mit Analgetikaintoleranz – gehäufte Therapieversager bei Langzeittherapie

Meeting Abstract

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  • corresponding author presenting/speaker Stefan Tesche - Medical School Hamburg. Department of Oto,-Rhino,-Laryngology/ Head and Neck-Surgery, Hamburg, Germany
  • Adrian Münscher - Medical School Hamburg. Department of Oto,-Rhino,-Laryngology/ Head and Neck-Surgery, Hamburg, Germany
  • Thomas Grundmann - Department of Oto,-Rhino,-Laryngology/ Head and Neck-Surgery - Asklepios Hospital Altona, Hamburg, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno088

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2006/06hno088.shtml

Published: September 7, 2006

© 2006 Tesche et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Recurrence of nasal polyps after sinus surgery is a common problem in patients with aspirin triad disease (ATD). Overproduction of leukotrienes accounts for the abnormalities in these patients.

Patients and Methods: We present the long term results of 13 patients with ATD, which were treated with Montelukast 10 mg daily after sinus surgery. The duration of follow up ranged from 9 to 84 months (mean: 39). Outcome measures included symptom scores and endoscopic findings.

Results: After follow up duration of 19 months (mean) we found a good local control of sinus symptoms and nasal polyposis in 10 of 13 patients. Only three showed relevant recurrence of polyps (23%). This number of patients increased during further follow up to 61 % within 9 to 84 months (mean: 31). No side effects of Montelukast occurred.

Conclusion: Long term medication of Montelukast showed a remarkable decrease of efficacy in controlling sinunasal polyposis in aspirin triad disease over time. The reasons are unclear.

Review of the latest literature showed a good disease control after desensitization therapy with only low maintenance doses of aspirin and therefore no or only few side effects. By date we recommend Montelukast as standby in cases of unsuccessful desensitization or contraindications and not as first therapy of choice.