The Role of Allergy Therapy in Chronic Rhinosinusitis: A Systematic Review

Abstract

The role of allergy in chronic rhinosinusitis (CRS) remains controversial. The objectives of the review were to determine if atopy plays a role in CRS, and to determine if allergy treatment impacts patient outcome. We screened 1,755 articles, resulting in 37 studies, of which 7 were prospective. No randomized controlled trials examining the benefit of immunotherapy in CRS were found in the literature. The study populations for the majority of the studies available were highly selected, evaluating patients failing medical therapy and often requiring endoscopic sinus surgery (ESS). Evidence from these studies suggests a high prevalence of atopy in CRS patients with a possible role of food allergy in CRS pathophysiology. Five of the 7 cohort studies in this review did not show a correlation between atopy and post-surgical outcome in CRS patients requiring ESS.