{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:21:35Z","timestamp":1790364095687,"version":"4.1.0"},"reference-count":75,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,7,12]],"date-time":"2014-07-12T00:00:00Z","timestamp":1405123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Allergic fungal rhinosinusitis (AFRS) is a subset of polypoid chronic rhinosinusitis that is characterized by the presence of eosinophilic mucin with fungal hyphae within the sinuses and a Type I hypersensitivity to fungi. The treatment of AFRS usually involves surgery in combination with medical therapies to keep the disease in a dormant state. However, what constitutes an optimal medical regimen is still controversial. Hence, the purpose of this article is to provide an evidence\u2010based approach for the medical management of AFRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systemic review of the literature on the medical management of AFRS was performed using Medline, EMBASE, and Cochrane Review Databases up to March 15, 2013. The inclusion criteria were as follows: patients &gt;18 years old; AFRS as defined by Bent and Kuhn; post\u2013sinus surgery; studies with a clearly defined end point to evaluate the effectiveness of medical therapy in postoperative AFRS patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This review identified and assessed 6 medical modalities for AFRS in the literature: oral steroids; topical steroids; oral antifungals; topical antifungals; immunotherapy; and leukotriene modulators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on available evidence in the literature, postoperative systemic and standard topical nasal steroids are recommended in the medical management of AFRS. Nonstandard topical nasal steroids, oral antifungals, and immunotherapy are options in cases of refractory AFRS. No recommendations can be provided for topical antifungals and leukotriene modulators due to insufficient clinical research reported in the literature.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21352","type":"journal-article","created":{"date-parts":[[2014,7,15]],"date-time":"2014-07-15T14:55:53Z","timestamp":1405436153000},"page":"702-715","source":"Crossref","is-referenced-by-count":111,"title":["Medical management of allergic fungal rhinosinusitis following endoscopic sinus surgery: an evidence\u2010based review and recommendations"],"prefix":"10.1002","volume":"4","author":[{"given":"Eng Cern","family":"Gan","sequence":"first","affiliation":[{"name":"St Paul's Sinus Centre Division of Otolaryngology\u2013Head and Neck Surgery University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Thamboo","sequence":"additional","affiliation":[{"name":"St Paul's Sinus Centre Division of Otolaryngology\u2013Head and Neck Surgery University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Rudmik","sequence":"additional","affiliation":[{"name":"Endoscopic Sinus and Skull Base Surgery Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery University of Calgary  Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"The Stanford Sinus Center Stanford University School of Medicine  Palo Alto CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berrylin J.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Division of Sino Nasal Disorders and Allergy Department of Otolaryngology\u2013Head and Neck Surgery University of Pittsburgh School of Medicine  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin 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