Nasal polyps, nasal polypectomy, asthma, and aspirin sensitivity

Abstract

In a retrospective study of 445 patients with nasal polyps, 95 (21%) had asthma. Forty-two (44%) of the patients with asthma were skin tested and 27 (60%) had positive reactions. Nasal polyps were twice as common in men as women, though women with nasal polyps were twice as likely to have asthma. The average age of onset of polyps was 39 yr and of asthma was 38 yr. No significant difference was found in the age of onset of polyps or asthma in various groups of patients. Two percent of all the patients in the series had nasal polyps, asthma and hypersensitivity to aspirin (the ASA triad). Ten per cent of those with polyps and asthma were hypersensitive to aspirin and thus had the full triad. Overall, 6% of all the patients in the series were recorded as being allergic to aspirin. Asthma developed more commonly before polypectomy than after in the ratio of 2.5:1. Around 1% of 1st polypectomies and 0.5% of all polypectomies were followed by the development of asthma within a few months. The onset of asthma was found to occur more frequently just before or just after the 1st polypectomy. Those who developed asthma after polypectomy had significantly more polypectomies than both non-asthmatics and those whose asthma preceded their polyps. Though polypectomy may on rare occasions precipitate asthma, it may not cause it.