Pediatric Allergic Fungal Rhinosinusitis: Does Age Make a Difference?

Area of Science:

• Pediatric Otolaryngology
• Allergy and Immunology
• Sinonasal Disorders

Background:

• Allergic fungal rhinosinusitis (AFRS) is an immune response to fungi in the sinuses.
• Pediatric sinonasal disorders are complex due to incomplete sinus development.
• Understanding AFRS in children is crucial for effective management.

Purpose of the Study:

• To investigate clinical manifestations of AFRS in children.
• To evaluate management outcomes of pediatric AFRS patients.
• To compare outcomes based on age at the time of sinus surgery.

Main Methods:

• Retrospective chart review of pediatric patients undergoing sinus surgery for AFRS (2005-2021).
• Data collected included demographics, clinical signs, imaging, lab results, treatments, and recurrence.
• Patients were sub-analyzed into two age groups: <13 years and ≥13 years.

Main Results:

• 35 children with AFRS underwent surgery; mean age was 14 years.
• Common findings included nasal polyps (88.6%), bilateral disease (42.9%), and anosmia (34.3%).
• Younger children (<13 years) had less bilateral disease and lower Lund-Mackay scores.

Conclusions:

• Age at the time of sinus surgery did not significantly affect AFRS outcomes in children.
• A high index of suspicion is needed for pediatric sinonasal symptoms unresponsive to treatment.
• Investigating AFRS is important for children with chronic sinusitis symptoms.