Update in the management of allergic fungal sinusitis

Abstract

Over the last 3 decades, allergic fungal sinusitis (AFS) has been defined as a clinically and pathologically distinct form of chronic rhinosinusitis. The etiology, pathogenesis, and natural history of the disease has not been fully understood, and the appropriate treatment for AFS is also controversial. The management of AFS includes a combination of functional endoscopic sinus surgery and medical treatment in the form of pre- and post-operative systemic steroids, local steroids, and allergic immunotherapy. Close follow-up and coordination between the surgeon and physician is needed for optimum outcome. Despite aggressive medical and surgical treatment, high recurrence rates have been reported. In this review, we study the current literature and data regarding various surgical and non-surgical treatment options for AFS.