Sphenoethmoidectomy: its role in the asthmatic patient.

Fifty patients who underwent intranasal sphenoethmoidectomy at the St Louis University Medical Center between July 1977 and April 1980 have been evaluated with respect to preoperative extent of disease and medication requirement as well as postoperative course and reduction in medication requirements, if any. These patients were followed jointly by the Departments of Allergy and Otolaryngology. Most of these patients were not allergic, and over half had intrinsic asthma. Fifteen of the 50 patients, all asthmatic, gave a history of aspirin sensitivity. Many had had previous nasal surgical treatment for polyps. Patients on large corticosteroid dosages had long-lasting reductions or elimination of their corticosteroid requirements in most cases. Similarly, most patients had long-lasting nasal airway improvement and reduction or elimination of recurring sinusitis. Antibiotics and antihistamine-decongestant preparations were sharply diminished in these patients. Although aspirin sensitivity was associated with some of the more severe asthmatic patients, it appeared not to be a factor in the responses to surgical treatment.