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Chapter 7: Allergic fungal rhinosinusitis

Adrienne M Laury1, Sarah K Wise

  • 1Applied Medical Research Center, St Vincent’s Hospital and University of New South Wales, and Macquarie University, Darlinghurst, Sydney, New South Wales, Australia.

American Journal of Rhinology & Allergy
|May 29, 2013
PubMed

Insights

Allergic fungal rhinosinusitis (AFRS) is a chronic sinus condition characterized by nasal polyps and fungal hypersensitivity. Research is clarifying its classification and pathophysiology, aiding treatment strategies.

Area of Science:

  • Otolaryngology
  • Immunology
  • Pathophysiology

Background:

  • Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis.
  • Characterized by nasal polyps, IgE-mediated hypersensitivity, eosinophilic mucin, and positive fungal stains.
  • Historically, AFRS affects immunocompetent individuals, with a higher prevalence in the southeastern and south-central United States.

Purpose of the Study:

  • To further elucidate the pathophysiology of AFRS.
  • To address ongoing debates regarding AFRS classification and disease predominance.
  • To provide a comprehensive overview of AFRS presentation and management.

Main Methods:

  • Review of existing literature on AFRS.
  • Analysis of clinical presentations and diagnostic findings.
  • Synthesis of current treatment approaches.

Main Results:

  • AFRS classically presents with sinus pressure, hyposmia, and congestion.
  • Radiographic findings often show unilateral, heterogeneously dense sinus material with potential bony erosion.
  • Eosinophilic mucin and positive fungal stains are key diagnostic indicators.

Conclusions:

  • Understanding AFRS pathophysiology is crucial for accurate classification and management.
  • Multimodal treatment, including surgery, irrigations, steroids, and immunotherapy, aims to reduce fungal load and immune response.
  • Continued research is necessary to refine understanding and treatment of this complex condition.

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