Triad Asthma

Triad asthma is a clinical syndrome defined by three conditions that exist together:

  • Asthma
  • Aspirin sensitivity
  • Nasal polyps

Triad asthma is also known as Samter’s triad or aspirin-related respiratory disease.

Triad asthma usually starts in patients over the age of 20 but can occur in younger adults or even children. In the adult clinics at the University of Michigan, most patients report the onset of symptoms between the ages of 20-40.

We have developed advanced treatment programs for patients with this disease, including postoperative aspirin desensitization – which is not commonly available in most community practices. Aspirin desensitization provides substantial relief and much better outcomes for about 70% of patients with triad asthma.

Why Proper Diagnosis is Important

Patients need to know if they have triad asthma because they may have very sudden, very severe asthma attacks that can be triggered by foods or medications. If you have triad asthma, you must be aware of your sensitivities to drugs and to some foods, and should take precautions to avoid them.

Triad asthma can be difficult to diagnose because not every patient has all three conditions at the same time.


We are experts in diagnosing and treating triad asthma. We begin with taking a good medical history, reviewing any records your physician has sent us, and possibly ordering CT (computed tomography) scans to take a good look at your sinus cavity to see the exact degree of sinus or nasal polyp disease.

A CT scan takes about 10-20 minutes and is usually quite easy for patients. Usually, there is no contrast dye or injection given for a sinus CT scan. If you have any claustrophobia or severe neck arthritis, let your physician and the radiologist know.


Before recommending surgery, we may prescribe saline sprays, daily salt-water irrigations, prescription steroid nasal sprays, or a short course of oral steroids.

Dr. Jeffrey Terrell has created a short video on Triad asthma and nasal polyps: an Otolaryngologist’s basic approach which would be very helpful to view before your appointment with one of our rhinologists.


Considering Surgery

The presence of nasal polyps alone is not necessarily an indication of surgery, because patients with this disease will almost always have some degree of nasal polyps. The decision to proceed with surgery depends on your symptoms and their impact on your lifestyle. Here are some general guidelines:

  • How bothered are you by nasal obstruction and the symptoms (i.e., snoring, losing sleep, continuously mouth breathing)?
  • How frequent and severe is your sinusitis? Sinus infections in patients with triad asthma are often difficult to clear because the sinuses do not drain well and the infected cavities become quickly reinfected once antibiotics are stopped.
  • Are your sinus problems and sinusitis making your asthma worse? Patients who require substantial amounts of oral steroid medications may be able to reduce their asthma medication requirements with successful surgery.
  • Are you experiencing chronic headaches or other signs of potential complications due to the polyps and sinus disease? Your Michigan Sinus Center specialist is qualified to assess these more unusual reasons for surgery.

Why Come to Michigan for Triad Asthma Treatment?

  • We treat more than 200 patients with this condition every year.
  • We take a multidisciplinary, step-by-step approach that takes you – as a whole person – into account.
  • Our aspirin desensitization treatment program provides relief for more than 70% of patients involved in treatment.
  • If you need us for surgery, trust the experts who perform more than 500 surgeries every year. And, when it comes to surgery, experience counts.