Allergic Fungal Rhinosinusitis - Outcomes of Multimodality Treatment

Abstract

Abstract Objective : To evaluate the treatment outcomes of multimodality therapy for allergic fungal rhinosinusitis. Study Design: Prospective Observational Study. Materials&methods : This study was carried out in the department of ENT & Head neck Surgery, Vivekananda Institute of Medical Sciences, Ramakrishna Mission Seva Pratishthan, Kolkata from January 2010 to July 2011. During this study period of one & half years, 20 subjects having Allergic Fungal Sinusitis were selected from all the patients having hypertrophic sinonasal disease. Pre-operative CT scans of nose & paranasal sinuses, total serum IgE estimation and absolute eosinophil count were performed in all cases. All patients were treated with 2 weeks of oral steroid preoperatively. Thereafter, all 20 patients underwent functional endoscopic sinus surgery, appropriate to their CT scan and operative findings. Post-operatively all the patients were treated with oral steroid and intranasal steroid spray according to Kuhn & Javer regimen, based on the endoscopic staging described by Kupferberg et al. Results and Analysis : During the follow up period, all cases were disease free at stage 0 after 6 weeks. After 6 months 11 (55%) cases were in stage II and 9 (45%) cases were in stage III. At 9 months follow up 17 (85%) cases recovered to stage I, 1 to stage II and 1 case became stage III. So the recurrence rate was (15%) at 9 months follow up. Keywords : Allergic fungal sinusitis, intranasal steroid spray, oral corticosteroid.

Keywords

• Sinusitis, Corticosteroids