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Published on: September 22, 2023

Allergic fungal rhinosinusitis: diagnosis and management

Matthew W Ryan1, Bradley F Marple

  • 1Department of Otolaryngology, The University of Texas Medical Branch, Galveston, Texas 77555-0521, USA. mwryan@utmb.edu

Current Opinion in Otolaryngology & Head and Neck Surgery
|January 11, 2007
PubMed
Abstract

Insights

Allergic fungal rhinosinusitis diagnosis is challenging. Key indicators include fungal-specific IgE and IgG3, bony erosion, and Type 1 hypersensitivity, aiding differentiation from other eosinophilic chronic rhinosinusitis forms.

Area of Science:

  • Otolaryngology
  • Allergy Immunology

Background:

  • Allergic fungal rhinosinusitis (AFRS) diagnosis and management are debated.
  • Significant overlap exists between AFRS and other eosinophilic mucin chronic rhinosinusitis (EMCRS) forms.

Purpose of the Study:

  • To review recent literature on diagnosing and treating AFRS.
  • To identify distinguishing features of AFRS.

Main Methods:

  • Literature review of recent studies on AFRS.
  • Analysis of clinical features, imaging, and immunological markers.

Main Results:

  • Type 1 hypersensitivity to fungi and specific CT findings may predict AFRS.
  • AFRS patients exhibit higher rates of bony erosion and orbital expansion compared to other EMCRS.
  • Fungal-specific IgE is common in allergic mucin; elevated fungal-specific IgG3 is consistent in AFRS and EMCRS.

Conclusions:

  • Type 1 fungal hypersensitivity is crucial for differentiating AFRS from other EMCRS.
  • Bony erosion and orbital expansion are characteristic of AFRS.
  • Further prospective, controlled trials are needed to advance medical treatment for AFRS.

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