Our Summary

This study looks at allergic fungal rhinosinusitis (AFRS), a condition that causes major issues for children. Although a lot has been written about this condition in adults, not much exists for children. The condition is marked by nasal polyps, an allergy to fungal proteins, thick mucus, and a rise in certain white blood cells. It seems that the disease is more aggressive in children, often causing bone damage and changes in the shape of facial bones. The current way to diagnose AFRS in children is by using the same criteria developed for adults. The main treatment is surgery followed by steroid treatment. Other treatments like antifungal medication, allergy shots, and biologics may help, but there isn’t a lot of evidence to back this up yet. To best help kids with AFRS, we need to diagnose and treat it as early as possible. The best approach is to do a comprehensive sinus surgery to open up the sinuses, remove the disease, and improve the effectiveness of the steroids given after surgery.

FAQs

  1. What is Allergic Fungal Rhinosinusitis (AFRS) and what are its symptoms in children?
  2. What are the current treatment options for AFRS in children?
  3. Why is early diagnosis and treatment important for children with AFRS?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully, including taking prescribed medications, avoiding activities that may increase nasal pressure (such as heavy lifting or blowing the nose forcefully), and attending follow-up appointments to monitor healing and address any concerns. It is also important to maintain good nasal hygiene, including using saline nasal rinses as directed to keep the nasal passages clear and prevent infection. Additionally, avoiding allergens or irritants that may contribute to nasal polyp growth can help prevent recurrence.

Suitable For

Patients who are typically recommended nasal polyp removal are those who have chronic sinusitis, nasal polyps that do not respond to other treatments, recurrent sinus infections, difficulty breathing through the nose, or other symptoms that significantly impact their quality of life. In the case of children with AFRS, surgery may be recommended if they have severe symptoms that do not respond to other treatments, or if there is evidence of bone damage or changes in facial structure. Early diagnosis and treatment are key to managing this condition in children and preventing long-term complications.

Timeline

Before nasal polyp removal:

  1. Patient experiences symptoms such as nasal congestion, postnasal drip, loss of smell, facial pain or pressure, and recurrent sinus infections.
  2. Patient undergoes a physical examination and imaging tests such as a CT scan to confirm the presence of nasal polyps.
  3. Patient may undergo allergy testing to identify any triggers for the condition.
  4. Patient may be prescribed medications such as nasal corticosteroids, antihistamines, or decongestants to manage symptoms.

After nasal polyp removal:

  1. Patient undergoes sinus surgery to remove the nasal polyps and improve sinus drainage.
  2. Patient may experience some discomfort and swelling in the nasal area immediately after surgery.
  3. Patient will be prescribed postoperative medications such as nasal steroids or antibiotics to prevent infection and promote healing.
  4. Patient will have follow-up appointments with their healthcare provider to monitor recovery and ensure the success of the surgery.
  5. Patient may experience improved symptoms such as better breathing, reduced nasal congestion, and improved sense of smell after recovery from surgery.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with nasal polyp removal surgery?
  2. What is the success rate of nasal polyp removal surgery in children with AFRS?
  3. How long is the recovery process after nasal polyp removal surgery?
  4. Will additional treatments such as antifungal medication or allergy shots be necessary after surgery?
  5. Are there any lifestyle changes or precautions that should be taken to prevent the recurrence of nasal polyps in the future?
  6. How frequently should follow-up appointments be scheduled after nasal polyp removal surgery?
  7. Are there any alternative treatment options available for children with AFRS?
  8. How can I best support my child during their recovery from nasal polyp removal surgery?
  9. What signs or symptoms should I watch for that may indicate a complication or recurrence of nasal polyps after surgery?
  10. Are there any long-term implications or effects of having nasal polyp removal surgery at a young age?

Reference

Authors: Suzuki M, Connell J, Psaltis AJ. Journal: Curr Opin Otolaryngol Head Neck Surg. 2021 Dec 1;29(6):510-516. doi: 10.1097/MOO.0000000000000761. PMID: 34545860