Folker RJ, Marple BF, Mabry RL, Mabry CS. Treatment of allergic fungal sinusitis: a comparison trial of postoperative immunotherapy with specific fungal antigens.
Laryngoscope 1998;
108:1623-7. [PMID:
9818816 DOI:
10.1097/00005537-199811000-00007]
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Abstract
OBJECTIVE
To determine the effect of immunotherapy (IT) with fungal antigens on clinical outcome in patients with allergic fungal sinusitis (AFS).
STUDY DESIGN
Prospective case control.
METHODS
In this comparison study, 22 patients meeting the diagnostic criteria of allergic fungal sinusitis (AFS) were evaluated after a mean of 33 months' therapy. All received similar treatment consisting of endoscopic sinus surgery, corticosteroids, and antibiotics as needed for complicating purulent sinusitis. Eleven patients received postoperative immunotherapy (IT) with fungal and nonfungal antigens to which sensitivity had been demonstrated, while the remaining 11 received no immunotherapy.
RESULTS
The effect of IT was to significantly improve patient outcome as assessed objectively by an AFS endoscopic mucosal staging system (P < .001) and a sinusitis-specific quality-of-life scale, the Chronic Sinusitis Survey (P = .002). In addition, IT was shown to reduce reliance on systemic (P < .001) and topical nasal (P = .043) corticosteroid therapy to control disease. Follow-up was similar in the two groups and was not a determinant of differences in outcome (P = .7).
CONCLUSIONS
Results from this study indicate that specific IT with fungal antigens improves patient outcome in AFS.
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