Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 3, Issue 5 | Case Report | Open Access
Akira yorozu*
1Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Japan
2Department of Otorhinolaryngology, Obihiro Kyoukai Hospital, Japan
3Department of Otorhinolaryngology, Ebetsu City Hospital, Japan
4Department of Otorhinolaryngology-Head and Neck Surgery, Obihiro Kousei Hospital, Japan
*Correspondence to: Akira yorozu
Fulltext PDFAllergic fungal rhinosinusitis (AFRS) is a chronic sinusitis characterized by type I and III allergic reactions to non-invasive fungi, resulting in the production of eosinophilic mucus. Here, we report a successful use of biologics in a patient with refractory AFRS who underwent multiple endoscopic sinus surgeries (ESSs), discussing our experience. The patient, a 45-year-old man with a history of bronchial asthma and dairy farming work, underwent the first ESS for bilateral chronic sinusitis in 2004. Although nasal sinus symptoms stabilized after the initial surgery, recurrent sinusitis let to six ESS procedures since 2012. Alongside surgical interventions, conservative treatments, including drug therapies and nasal cavity rising, improved nasal congestion and discharge but left residual right eye pain. In February 2020, benralizumab was initiated for asthma treatment in the pulmonary medicine department, leading to significant improvement in the right eye pain. Three years post-treatment commencement, no recurring symptoms have been observed. As AFRS is rare, treatment guidelines are yet to be established. Although biologics for chronic rhinosinusitis with nasal polyp have gained attention, biologics for AFRS have limit reported cases. This report suggests that anti-IL-5 receptor antibodies are effective against AFRS; however, their precise mechanism remains unclear. Further investigations into the pathogenesis of AFRS and the application of biological agents are warranted.
Akira Yorozu, Kizuku Owada, Fumie Ito, Ryoto Yajima, Takuya Kakuki, Ryo Miyata, et al. A Case Report of Refractory AFRS That Appears to Have Been Successful with Benralizumab. Annal of Otol Head and Neck Surg. 2024;3(5):1-7.