Abstract | INTRODUCTION: METHODOLOGY: A prospective study was carried out from July 2011 to November 2013 with 27 patients with histologically proven AFS, who were given itraconazole for 1 month in the preoperative period and operated after completion of the course of itraconazole. They were compared with 25 matched controls of patients with AFS who were operated on directly without preoperative itraconazole. Both groups were given oral steroids in tapering doses for 6 weeks during the postoperative period and followed up at regular intervals. Evaluations were done by using symptomatic (Sino-Nasal Outcome Test [SNOT-20]), radiologic (Lund Mackay scores), and endoscopic (Kupferberg nasal endoscopic grades) parameters. RESULTS: Symptomatology scores (SNOT-20) decreased significantly (p = 0.000) with itraconazole. There was a decrease (p = 0.007) in the Lund Mackay scores that reached up to 0. There was complete resolution of disease in 15% of the patients. Reductions in hyperdensities were noted on computed tomography in all the patients after preoperative itraconazole. Polyp sizes decreased and nasal endoscopic grades improved after itraconazole. Postoperative fungal cultures were positive in 60% of the patients in the preoperative itraconazole group compared with 76% of the patients in the control group, which indicated a decreased fungal burden. CONCLUSION: We found improvements in clinical, radiologic, and endoscopic parameters in AFS after preoperative itraconazole administration, which decreased the disease load significantly and also reduced the extent of surgery in the short-term follow-up. It may prove to be a good preoperative adjunct that needs further research.
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Authors | Sourabha K Patro, Roshan K Verma, Naresh K Panda, Arunaloke Chakrabarti, Paramjeet Singh |
Journal | American journal of rhinology & allergy
(Am J Rhinol Allergy)
2015 Jul-Aug
Vol. 29
Issue 4
Pg. 299-304
ISSN: 1945-8932 [Electronic] United States |
PMID | 26163250
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Antifungal Agents
- Itraconazole
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Topics |
- Adult
- Antifungal Agents
(administration & dosage)
- Female
- Follow-Up Studies
- Hospitals, University
- Humans
- Itraconazole
(administration & dosage)
- Male
- Middle Aged
- Mycoses
(complications)
- Preoperative Care
- Prospective Studies
- Recurrence
- Rhinitis, Allergic
(drug therapy, microbiology, surgery)
- Sinusitis
(drug therapy, microbiology, surgery)
- Time Factors
- Treatment Outcome
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