OBJECTIVE: To review the literature on the occurrences of aural polyps in patients with Samter's triad with a focus on familiarizing clinicians with the clinical presentation and the etiologic and therapeutic issues of this entity. STUDY DESIGN: Published reports of otologic manifestations of Samter's triad were reviewed in conjunction with 1 case presenting at University of California at San Diego medical center. SETTING: Academic, tertiary referral hospital PATIENTS AND INTERVENTIONS: The patient underwent bilateral aural polypectomy, tympanoplasty, mastoidectomy, and placement of tympanostomy tubes, revealing substantial polypoid tissue growth filling the external ear canal, middle ear space, and Eustachian tube. RESULTS: Aural polyps associated with Samter's triad reported to date have been bilateral and are associated with conductive hearing loss, persistent otorrhea, and aural fullness. They also display a tendency to recur despite surgical resection. Histopathology in our patient confirmed aural polyposis in the external auditory canal, middle ear, and mastoid air cells with striking resemblance to the typical sinonasal allergic polyp. Patient's otologic symptoms and hearing improved after surgical excision. CONCLUSION: We speculate that this patient's aural polyposis is secondary to the immunologic dysfunction and chronic otologic inflammation from Samter's syndrome. This has only been described once previously in literature. Its tendency to recur warrants complete surgical resection, concomitant medical management of the syndrome including steroid and aspirin desensitization, and long-term follow-up with imaging.
OBJECTIVE: To review the literature on the occurrences of aural polyps in patients with Samter's triad with a focus on familiarizing clinicians with the clinical presentation and the etiologic and therapeutic issues of this entity. STUDY DESIGN: Published reports of otologic manifestations of Samter's triad were reviewed in conjunction with 1 case presenting at University of California at San Diego medical center. SETTING: Academic, tertiary referral hospital PATIENTS AND INTERVENTIONS: The patient underwent bilateral aural polypectomy, tympanoplasty, mastoidectomy, and placement of tympanostomy tubes, revealing substantial polypoid tissue growth filling the external ear canal, middle ear space, and Eustachian tube. RESULTS:Aural polyps associated with Samter's triad reported to date have been bilateral and are associated with conductive hearing loss, persistent otorrhea, and aural fullness. They also display a tendency to recur despite surgical resection. Histopathology in our patient confirmed aural polyposis in the external auditory canal, middle ear, and mastoid air cells with striking resemblance to the typical sinonasal allergic polyp. Patient's otologic symptoms and hearing improved after surgical excision. CONCLUSION: We speculate that this patient's aural polyposis is secondary to the immunologic dysfunction and chronic otologic inflammation from Samter's syndrome. This has only been described once previously in literature. Its tendency to recur warrants complete surgical resection, concomitant medical management of the syndrome including steroid and aspirin desensitization, and long-term follow-up with imaging.
Authors: James G Naples; Andrew Corr; Siddhant Tripathi; Morgan Berman; Jason A Brant; Michael J Ruckenstein; John Bosso Journal: World J Otorhinolaryngol Head Neck Surg Date: 2020-10-17