Fungal sinusitis is one of the important cause of nasal polyposis. Surgical clearance is of course the main treatment for this, as most of us agree. Most, if not all invasive forms require systemic antifungal treatment. What is the role of antifungal medication in allergic fungal sinusitis?
Thank you Jahnavi Srividya for your feedback.. How long oral itraconazole should be given after surgery? Is this to be given in all patients of AFS, or only selected ones? what are the guidelines to start and discontinue oral antifungal therapy, if given?
Fungal sinusitis is not always due to aspergillosis and not treated with iatroconazole alone. The options for post operative care would depend on the invasivenesss of the fungus,it's sensitivity, the immune status of the patient (AFRS or otherwise), and the completeness of resection in the inaccessable area. Indeed, mucormycosis is different fron AFRS. Iatroconazole, voriconazole and ampotericin B are used . The options for post op care would vary from steroid therapy to ampotericin B as the need dictates. We cannot treat all "polyps" with fungal sinusitis as one.
In allergic fungal sinusitis, no role for systemic antifungal drugs.surgery: FESS IS THE MAIN LINE OF TTT followeed by meticulous follow up and topical and systemic steroids
fungal balls in sinuses also no role for systemic antifungals, only local clearence with the endoscope .
invasive fungal sinusitis is ttt by systemic antifungals, aggressive local debridement by the endoscope and measures to improve the general condition and immunity
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