Role of postoperative medical treatment in the management of allergic fungal sinusitis

ABSTRACT

To evaluate the effectiveness, of postoperative medical treatment in the management of allergic fungal sinusitis with orbital and/or skull base erosion. Descriptive study. This study was conducted in the Department of ENT and Head and Neck Surgery, Khyber Medical College and Khyber Teaching Hospital Peshawar between January 2002 and April 2007. Eighteen cases of allergic fungal sinusitis with orbital and/or skull base erosion were selected for the study. Demographic data like, name, age, sex, address, clinical features, labs and imaging studies were recorded, clinical data including the pre and post-operative medical treatment, operative findings and postoperative results, recurrence of disease were recorded. All patients were divided into three groups on the basis of postoperative medical treatment. Study revealed that Allergic Fungal Sinusitis [AFS] is a disease of younger age, mainly occurring in 2[nd] and 3[rd] decade of life, with male to female ratio 11.25. The recurrence was 100% in group-l who were on oral antifungal therapy postoperatively. The recurrence of disease was 40% in patients of group-2 who were on topical nasal steroid, antihistamine and saline irrigation postoperatively. The recurrence rate was much lower 11% in group-3 patients who received oral and topical nasal corticosteroids postoperatively. AFS is a disease of young immunocompetent adults. Surgical debridement and drainage combined with topical and oral corticosteroids can lead to resolution of disease in majority of the cases and prevent recurrences. Antifungal medication has no role in the treatment of allergic fungal sinusitis