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ENT · Nose and paranasal sinuses: aspirin desensitisation
Sample itemA man with asthma, nasal polyps and reactions to aspirin has had two sinus operations, and the polyps keep recurring despite intranasal steroids. Which additional option can reduce recurrence?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Aspirin desensitisation followed by daily aspirin
In aspirin-exacerbated respiratory disease, controlled desensitisation followed by daily aspirin reduces polyp regrowth and asthma symptoms. It must be done under supervision. Other COX-1 inhibitors cross-react and will trigger reactions.
Option by option
A. Repeated antihistamine courses
Antihistamines do not treat polyps driven by leukotriene overproduction.
B. Aspirin desensitisation followed by daily aspirin (correct)
Correct. Supervised desensitisation with daily aspirin can reduce polyp recurrence in AERD.
C. Nasal decongestant sprays
Decongestants give short relief but worsen rhinitis medicamentosa and do not stop polyps.
D. Lifelong ibuprofen as an alternative
Ibuprofen is a COX-1 inhibitor and cross-reacts, so it would trigger an attack.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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