Management protocols of Allergic Fungal Sinusitis |
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Authors: | Dr. Rishi Pal Gupta Sudhir Bahadur Alok Thakar K. K. Handa Chitra Sarkaar |
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Affiliation: | 1. Department of Otolaryngology & Head and Neck Surgery, C/o Mrs. Anita Pal Gupta H. No. B-2/157, Teacher’s Colony, Nawanshahr, Punjab, India 2. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Abstract: | Controversy surrounds the appropriate surgical approach and the appropriate medical therapy for Allergic Fungal Sinusitis. The present prospective study aims to assess the impact of these factors on the treatment outcome of Allergic Fungal Sinusitis. In the present study 34 cases with AFS were randomized into one of 3 methods of post operative therapy i.e. systemic itraconazole (group A, n=11), topical steroids (group B, n=12) and nasal alkaline douches only (group C, n=11). Outcome was assessed at 6 months post-operative by the Kupferberg grading system for assessment of nasal and sinus mucosa. Grade ‘3’ mucosal disease was defined as recurrence. Complete pre-operative opacification of sphenoid and frontal sinus was a predictor of poorer outcome. Postoperative systemic itraconazole therapy demonstrated a trend towards a better outcome but was not statistically significant. Larger trials are required to conclusively evaluate the merit of various post-operative treatment regimens for AFS. |
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Keywords: | Aspergillosis paranasal sinus itraconazole endoscopic sinus surgery |
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