Yes - allergen immunotherapy is a well-established treatment option for patients with chronic sinusitis that has a confirmed allergic component, and its role is particularly important in patients who have had sinus surgery and want to reduce the risk of recurrence. The mechanism is direct: allergen immunotherapy gradually reduces the IgE-mediated immune response to the specific allergen, producing a shift from allergic Th2-type reactivity toward immune tolerance. Over the course of the treatment - typically three to five years - this reduces the allergen-driven mucosal inflammation that feeds sinusitis episodes and nasal polyp formation. The evidence for allergen immunotherapy in allergic sinusitis is strongest for house dust mite sensitisation, which is the most prevalent sensitisation in Bengaluru ENT patients, and for pollen sensitisation in patients with seasonal exacerbations. For patients who have had FESS and want to protect their surgical outcome, immunotherapy is one of the most clinically evidence-based interventions available - reducing the inflammatory driving force means extending the period of good sinus function after surgery. It is offered as subcutaneous injections in clinic during a build-up phase followed by monthly maintenance, or as daily sublingual drops or tablets at home. FAAI training informs my selection of appropriate candidates - not every allergic rhinitis patient needs immunotherapy, but those with significant allergen-driven sinusitis who are committed to a multi-year treatment course achieve outcomes that pharmacotherapy alone cannot sustain.
Written by Dr. Deeksha Bhaskar Shetty, MBBS, MS (Otorhinolaryngology), FAAI (Fellowship in Allergy, Asthma and Immunology), Consultant Otolaryngologist (ENT Specialist), Bengaluru. Phone: 9538390563.
