Otologic Complications in Aspirin Exacerbated Respiratory Disease
Monday, March 5, 2018
South Hall A2 (Convention Center)
Jyotsna Mullur, MD, Jing Cui, MD, PhD, Rachel Roditi, MD, Katherine N. Cahill, MD
RATIONALE: Otologic complications, including hearing loss, have been reported in chronic rhinosinusitis with nasal polyposis but have yet to be characterized in Aspirin Exacerbated Respiratory Disease (AERD).

METHODS: 450 patients enrolled in the Brigham and Women’s Hospital (BWH) AERD patient registry were surveyed for otologic symptoms. Corresponding demographic and disease data were extracted from the BWH AERD patient registry. Statistical significance was assessed with logistic regression, Chi-square tests, and two-tailed t-tests.

RESULTS: 292 of 450 questionnaires were completed (64.8%). 64 patients reported a prior diagnosis of hearing loss (21.9%). Further analysis excluded seven patients with congenital or traumatic hearing loss. 144 (49.3%) reported a history of adulthood middle ear symptoms (MES), defined as ear infections requiring antibiotics, middle ear effusion, or chronic ear drainage. At the time of survey, patients with hearing loss were older (54.8±1.7 vs 48.0±0.8 years, p=0.0002), and had a longer duration of nasal polyposis (20.3±1.6 vs 12.4±0.6 years, p<0.0001) than those without. There was no difference in current age between those with and without MES. There was no difference in age of nasal polyposis onset between those with and without MES and hearing loss. Odds of hearing loss increased with each additional year of nasal polyposis (OR=1.06 per year [1.04-1.10, p<0.0001]) and history of MES (OR=3.31 [1.76-6.24, p=0.002]). Hearing loss and MES were not associated with time to polyp regrowth after polypectomy.

CONCLUSIONS: Otologic complications in AERD are common. Duration of nasal polyps and history of MES, independent of age, are risk factors for hearing loss in patients with AERD.