A new study published in International Forum of Allergy & Rhinology assessed whether recent endoscopic sinus surgery (ESS) improved aspirin treatment outcomes in aspirin-exacerbated respiratory disease (AERD) patients who initially failed aspirin therapy. Here, outcomes of aspirin desensitization and treatment in AERD patients prospectively enrolled, were assessed preoperatively and at 4, 12 and 24 weeks after ESS by determining changes in Asthma Control Test (ACT) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and respiratory function. Overall, 19 patients who benefited (responders) and 21 patients who failed (non-responders) preoperative aspirin treatment, with a distant history of ESS, were identified. The findings revealed that non-responders were more likely to be African American (71%) and have higher baseline immunoglobulin E (IgE) levels (252 kU/L vs 87 kU/L in responders). Meanwhile, 24 of the 40 patients (nine responders and 15 non-responders) required subsequent ESS and underwent another aspirin desensitization, 3-4 weeks after ESS. All 24 patients tolerated a second round of aspirin desensitization and treatment. The primary aspirin therapy was associated with a significant increase in IgEamong non-responders, but there was no significant increase in IgE after the second aspirin desensitization and treatment.It was concluded that antecedent ESS enhances aspirin treatment responses in AERD patients and may convert patients who failed aspirin treatment before surgery to a more responsive phenotype after ESS. In addition, patients with higher baseline serum IgE levels may benefit from ESS performed shortly before aspirin desensitization and therapy.