AFRS is characterized by higher revision ESS rates and unique radiographic features when compared to CRSwNP or CRSsNP.

Researchers hypothesized that an increased frequency of concha bullosa in AFRS or other radiographic nuances might allow for the accumulation of allergic mucin and contribute to increased ESS revision rates.

The present study was a retrospective cohort study. Patient diagnosis, basic demographics, and prior ESS rates were collected.

Researchers included a total of 210 consecutive patients. Pediatric AFRS patients had the more unilateral disease and anterior ethmoid skull base erosion than adult AFRS patients. AFRS patients were more likely to be younger, African American, and have undergone prior ESS than CRSwNP or CRSsNP patients. Concha bullosa was more prevalent in AFRS patients than CRSwNP or CRSsNP patients across the population and in the setting of no previous surgery.

The study concluded that pediatric AFRS patients had a more unilateral disease and anterior ethmoid skull base erosion. Concha bullosa prevalence was significantly higher in AFRS than those with CRSwNP or CRSsNP, despite prior ESS. Surgeons should consider concha bullosa as a potential anatomical subsite to harbor recurrent or residual disease.