[The effect of steroid therapy on post adenotonsillectomy recovery].

BACKGROUND: Previous studies on dexamethasone's antiemetic and antinflammatory potential in patients undergoing adenotonsillectomy have produced conflicting results. OBJECTIVES: To determine the effect of intraoperative I.V. single dose dexamethasone on recovery and complications after adenotonsillitis while anesthesia techniques, surgical techniques and perioperative treatment are standardized. DESIGN: Prospective randomized, controlled study. METHODS: A total of 230 patients aged 2-16 years undergoing elective adenotonsillectomy enrolled in the study. Patients were randomly assigned to receive i.v. dexamethasone 0.5 mg/kg (study group), or no treatment (control group). Pain score, emesis, oral intake and bleeding were assessed on the first and tenth postoperative day. RESULTS: Overall, 204 completed the study, 101 in the study group, 103 in the control group. It was found that intraoperative single I.V. dexamethasone significantly reduces emesis during the first postoperative day (P < 0.0001), significantly reduces pain score on the first (P < 0.0001), and tenth postoperative day (P = 0.053), significantly increases the number of patients returning to soft diet on the first postoperative day (P = 0.0002) and normal diet on the tenth postoperative day (P < 0.0001). No significant difference in bleeding tendency between the two groups was noted (P = 0.7202). CONCLUSIONS: Intraoperative injection of I.V. dexamethasone 0.5 mg/kg effectively reduced post adenotonsillectomy morbidity.

[Allergic fungal sinusitis: diagnostic, therapeutic and prognostic evaluation].

Allergic Fungal Sinusitis (AFS) is a benign noninvasive sinus disease related to hypersensitivity to fungal antigen. The incidence of the disease has been estimated to be 4-7% of patients requiring surgery for chronic sinusitis. AFS is characterized by high levels of IgE in the atopic patient's serum, and the presence of allergic mucin that contains eosinophils and fungal components. The treatment of AFS entails endoscopic sinus surgery, combined with pre- and post-operative systemic and local steroid treatment. This article summarizes the clinical course of 11 patients treated in our department for AFS between the years 1996 and 2002 and followed-up for more than twelve months. We review the characteristics of AFS, the diagnostic criteria, the treatment protocol and the prognostic outcome in these patients.