2018 Section 5 - Rhinology and Allergic Disorders

Medical management of AFRS

( Continued )

2. Improvement quality of life ( p = 0.002).

3. Reduce reliance on systemic ( p <

mucosal staging ( p < 0.001).

0.001) and topical ( p = 0.043)

Conclusion

None 1. Improvement endoscopic

corticosteroids.

None Clinical suspicion IT reduces

reaccumulation of

crusts and allergic

mucin, topical and

systemic steroids,

and improved quality of life.

None Continue to support

findings from original study.

side

effects

Complications/

clinical

Primary

end points

1. Endoscopic mucosal staging.

2. Chronic Sinusitis

Survey.

3. Corticosteroid requirements.

1. Evidence of recurrent disease.

requirements.

3. Complicating secondary infections.

1. Evidence of recurrent disease.

requirements.

3. Complicating secondary infections.

outcomes

2. Medication

2. Medication

4. Adverse

protocol

Treatment

Highest tolerated

concentration given to

fungal and antifungal

antigens sensitivities;

minimum 12 months treatment

IT given weekly basis

based on sensitivities to fungal and antifungal antigens up to 12

months; highest tolerated concentration given

IT given initially weekly

for a year then extended to biweekly basis; total average therapy 20

months; IT based on

sensitivities to fungal and antifungal antigens

Study

groups

Folker et al. 67 1998 Case control Fulfilled 3b 22 1. Immediate postoperative AFRS group; immunotherapy with fungal and nonfungal antigens,

corticosteroids, antibiotics.

postoperative

AFRS group;

corticosteroids, antibiotics

4 10 (1) Single

postoperative AFRS group

4 9 (1) Single

postoperative AFRS group

2. Immediate

Subjects (n)

TABLE 6. Immunotherapy in postoperative AFRS summary Level of evidence

Bent and Kuhn

criteria

Fulfilled (however, does

not clearly state if Type I hypersensitivity tested)

Partially fulfilled (7 tested for Type I

hypersensitivity, unclear with other patients)

authors Year Study

design

case series

case series

1997 Prospective

1997 Prospective

Mabry and Mabry 71

Mabry et al. 70

Study

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