Effect of zafirlukast on hyperplastic rhinosinusitis

Abstract

A 70-year-old male with a history of nasal congestion, rhinorrhea, sinusitis and asthmatic attacks since he was 50 years old was followed-up in our clinic as a diagnosis of aspirin triad for 9 years, during which a variable medications and treatment protocols including oral prednisolone, usually in a maintainance dose of 10 mg on the other day but sometimes given in doses of 40-50 mg/day within short intervals, inhaler and nasal steroids and bronchodilators and ketotifen and also classic sinusitis therapies consisting of antibiotics, antihistaminics and nasal vasoconstrictors were administered to him. Although his asthmatic symptoms partially resolved, pansinusitis, nasal polyps and nasal congestion persisted. Zafirlukast which is a leukotrien receptor antagonist (LTRA) was added to therapy in a dose of 20 mg bid and control paranasal sinus CT scans taken after two months revealed almost complete aeration of both maxillary and sphenoid sinuses with partial aeration of left frontal sinus and also there was a marked decrease in previous soft tissue lesions located in middle meatus resulting near-normalisation of nasal passages. Also, his nasal complaints decreased. To our knowledge, our case is the first case showing effectivity of LTRA on hyperplastic rhinosinusitis in literature.