Journal Mobile Options
Table of Contents
Vol. 61, No. 3, 1999
Issue release date: May–June 1999
ORL 1999;61:146–150

Aspirin Intolerance in Patients with Chronic Sinusitis

Gosepath J. · Hoffmann F. · Schäfer D. · Amedee R.G. · Mann W.J.
aDepartment of Otolaryngology, University of Mainz, School of Medicine, Mainz, Germany; bTulane University Medical Center, New Orleans, School of Medicine, New Orleans, La., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Aspirin intolerance in patients with chronic sinusitis is often a cause of early recurrence of symptoms after surgical treatment. This study assesses 84 patients who were tested for acetylsalicylic acid intolerance after presenting with symptoms like chronic rhinosinusitis, sometimes bronchial asthma, coexisting allergies or a history of aspirin sensitivity. Nasal polyposis was found in a majority of cases, often recurrent after previous surgery. The levels of eicosanoids such as peptido-leukotrienes and prostaglandin E2 were analyzed in isolated blood cells and compared with a healthy control group. Aspirin-intolerant patients showed elevated basal levels of peptido-leukotrienes and reduced basal levels of prostaglandin E2. Test results were graded in a system ranging from positive (68%), signifying aspirin intolerance, to borderline (18%) and negative results (14%). After screening patients with clinical findings indicating a possible aspirin intolerance, the results of this investigation reveal a strong correlation between the clinical symptomatology and the in vitro parameters of eicosanoid levels in isolated blood cells, indicating the need to induce aspirin tolerance to reduce the risk of recurrent rhinosinusitis.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Delany JC: Aspirin idiosyncrasy in patients admitted for nasal polypectomy. Clin Otolaryngol 1976;1:27–32.

    External Resources

  2. Samter M, Beers RF: Intolerance to aspirin: Clinical studies and considerations of pathogenesis. Ann Intern Med 1968;68:975–983.
  3. Widal MF, Abramin P, Lermoyez J: Anaphylaxie et idiosyncrasy. Presse Méd 1922;30:189–193.
  4. Meikle D: Aspirin sensitivity and recurrent polyposis. Clin Otolaryngol 1988;13:1–3.

    External Resources

  5. Szczeklik A, Gryglewski RJ, Czerniawskamysik G: Relationship of inhibition of prostaglandin biosynthesis by analgesics to asthma attacks in aspirin sensitive patients. BMJ 1975;i:67–69.
  6. Jäntti-Alanko S, Holopainen E, Malmberg H: Recurrence of nasal polyps after surgical treatment. Rhinol Suppl 1989;8:59–64.

    External Resources

  7. Larsen K: The clinical relationship of nasal polyps to asthma. Allergy Asthma Proc 1996;5:243–249.
  8. Brasch J, Doniec M, Mertens J, Wellbrock M: Intolerance to acetylsalicyl acid associated with nasal polyps/rhinosinusitis: Frequency, diagnostic tests and therapy. Allergologie 1994;5:197–203.
  9. Giampiero P, Paolo B, Domenico S, Giuseppe P, Guiseppina S, Giovanna F, Rita PL: Intranasal treatment with lysine acetylsalicylate in patients with nasal polyposis. Ann Allergy 1991;6:588–592.
  10. Lumry WR, Curd JG, Zeiger RS, Pleskow WW, Stevenson DD: Aspirin-sensitive rhinosinusitis: The clinical syndrome and effects of aspirin administration. J Allergy Clin Immunol 1983;6:580–587.
  11. Schaefer D, Schmied M, Goede U, Baenkler HW: Dynamics of eicosanoids in peripheral blood cells during bronchial provocation in aspirin intolerant asthmatics. Eur Respir J, in press.
  12. Schaefer D, Lindenthal U, Wagner M, Bölczkey PL, Baenkler HW: Effect of prostaglandin E2 on eicosanoid release by human bronchial biopsy specimens from normal and inflamed mucosa. Thorax 1996;51:919–923.
  13. Mewes T, Riechelmann H, Klimek L: Increased in vitro cysteinyl leukotriene release from blood leukocytes in patients with asthma, nasal polyps and aspirin intolerance. Allergy 1996;7:506–510.
  14. Patriarca G, Romano A, Schiavino D, Venuti A, Rienzo V, Fais G, Nucera E: ASA disease: The clinical relationship of nasal polyposis to ASA intolerance. Arch Otorhinolaryngol 1986;243:16–19.

    External Resources

  15. Probst L, Stoney P, Jeney E, Hawke M: Nasal polyps, bronchial asthma and aspirin sensitivity. J Otolaryngol 1992;1:60–65.
  16. Samter M, Zeitz HJ: The aspirin triad and the prostaglandins; in Samter M (ed): Immunological Diseases, ed 3. Boston, Brown, 1978, vol II.
  17. Kietzmann H, Brasch J, Rahmel U: Acetylsalicylic acid tolerance induction as treatment for rhinosinusitis and nasal polyposis in acetylsalicylic acid sensitive patients. Atemwege 1987;5:107–110.
  18. Knight A: Desensitization to aspirin in aspirin-sensitive patients with rhino-sinusitis and asthma: A review. J Otolaryngol 1989;4:165–167.
  19. Schapowal AG, Simon HU, Schmitz-Schumann M: Phenomenology, pathogenesis, diagnosis and treatment of aspirin-sensitive rhinosinusitis. Acta Otorhinolaryngol Belg 1995;49:235–250.
  20. Sainte-Laudy J: Importance of in vivo and in vitro studies of leukotrienes: Application to the particular instance of aspirin. Allerg Immunol 1997;2:28–35.
  21. Slepian IK, Mathewes KP, McLean JA: Aspirin sensitive asthma. Chest 1985;87:386–391.

    External Resources

  22. Boettcher FA, Salvi RJ: Salicylate ototoxicity: Review and synthesis. Am J Otolaryngol 1991;12:33–47.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50