الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Allergic fungal rhinosinusitis is considered one of the most important subtypes of noninvasive fungal rhinosinusitis seen in immunocompetent individuals with an incidence of 5 to 10 % of all cases of chronic rhinosinusitis requiring surgery.
The standard current treatment for control of AFRS is endoscopic sinus surgery followed by systemic and/or topical steroids. Although many patients are usually improved by this treatment, recurrence was noticed even in the early postoperative period beside the serious side effects of long-term use of steroids.
Understanding the pathogenesis and immunological basis of AFRS is essential for disease control. It is due to the continuous exposure of fungal antigens to an atopic individual. It is caused by type I, IgE mediated (and possibly type III) hypersensitivity reaction to an extramucosal fungal antigen. That is why omalizumab is helpful. It acts by aborting the immunological reaction to sinonasal fungi through preventing the release of inflammatory mediators that cause allergic signs and symptoms.
Our study is considered one of the very few randomized control trials testing the role of single dose of omalizumab in management of AFRS in comparison to a standard treatment modality (topical steroid).
Using omalizumab as a single dose subcutaneous injection postoperatively was effective within our study in controlling disease up to 6 months. It was better than local steroids in controlling nasal symptoms and subjective parameters despite the same endoscopic scores post-treatment.
The high cost of omalizumab remains the main obstacle. However, drug compliance for single subcutaneous injection of omalizumab was higher than using topical nasal steroids twice daily for 6 months.
Further studies on omalizumab in AFRS are needed. Prolonged study periods for longer follow-up of patients in the future with determination of optimum dosage and duration of omalizumab therapy are necessary.