Inclusion Criteria:  Subjects >18 years old with Aspirin-Exacerbated Respiratory Disease  This is diagnosed via either a positive oral aspirin or intranasal ketorolac challenge OR a history of at least two stereotypical hypersensitivity reactions to aspirin leading to nasal-ocular symptom and/or asthmatic symptoms.  -All subjects will be required to have a known history of nasal polyposis either via imaging, endoscopy, or nasal examination  Exclusion Criteria:  History of gastrointestinal reactions (severe abdominal pain with or without vomiting) during NSAID triggered events Unstable asthma or history of severe reactions during previous desensitization attempts inability to take montelukast pretreatment history of gastrointestinal bleeding or bleeding disorder pregnancy ongoing treatment with an asthma biologic or dupilumab previous use of an asthma biologic of dupilumab in the past 3 months need for systemic corticosteroids to stabilize asthma prior to challenge time from sinus surgery <1 month.