Allergic Fungal Rhinosinusitis Diagnosis, Management, Associated Conditions, Pathophysiology, and Future Directions: Summary of a Multidisciplinary Workshop
Lauren T. Roland, Cecelia Damask, Amber Luong, Antoine Azar, Charles S. Ebert, Thomas S. Edwards, Katherine N. Cahill, Do‐Yeon Cho, David B. Corry, Tara L. Croston, Alexandra F. Freeman, Amin Javer, Paneez Khoury, Jean Kim, Michael Koval, Edward D. McCoul, James W. Mims, Anju T. Peters, Jay F. Piccirillo, Richard P. Ramonell, Amali E. Samarasinghe, Robert P. Schleimer, Prestina Smith, Andrej Spec, Michael E. Wechsler, Sarah K. Wise, Joshua M. Levy
Abstract
Allergic fungal rhinosinusitis (AFRS) is a unique endotype of chronic rhinosinusitis with nasal polyps (CRSwNP). Despite high recurrence rates and often more severe presenting signs compared with other subtypes of CRSwNP, research dedicated to AFRS has been lacking. Diagnostic criteria are outdated, the mechanistic relationship of AFRS to other associated diseases is unclear, and the pathophysiology of disease and risk factors for recurrence have not been well studied. In December 2023, a multidisciplinary group of rhinologists, otolaryngologists, pulmonologists, allergists, immunologists, scientists, and infectious disease experts met at the National Institute of Health to discuss unmet needs for future AFRS research and care, including patient management, diagnostic criteria, severity, pathophysiology, and related conditions. A summary of these clinical and associated research discussions is included below.