Evaluation of the effect of systemic antifungal on the Radiologic and Endoscopic outcome after Endoscopic Sinus Surgery in patients with Allergic Fungal Rhinosinusitis

Hamead, Khalaf; Singer, Abd El Rehim; Ahmed, Mostafa Ismail; Abdelhakim, Abdelhakim Atef; Abdelzaher, Khaled Mohammed

doi:10.21608/mjmr.2025.348588.1863

Evaluation of the effect of systemic antifungal on the Radiologic and Endoscopic outcome after Endoscopic Sinus Surgery in patients with Allergic Fungal Rhinosinusitis

Articles in Press

Document Type : Original Article

Authors

¹ otorhinolaryngology department ,faculty of medicine, Minia university

² otolaryngeology department, faculty of medicine,minia university

³ ENT department,Faculty of Medicine, Minia University

⁴ Department of Otorhinolaryngology, faculty of medicine, Minia University

⁵ E.N.T department Faculty of Medicine -El- Minia University Egypt

10.21608/mjmr.2025.348588.1863

Abstract

Abstract

Background: Allergic Fungal Rhinosinusitis (AFRS) is a serious problem that affects quality of life. With Limited effective postoperative therapies existing we discuss the role of systemic Itraconazole as an adjunctive therapeutic agent postoperatively.

Aim of the study: Evaluation of the effect of systemic Itraconazole after functional endoscopic sinus surgery (FESS) in Allergic Fungal Rhinosinusitis patients.

Patients and methods: In the study, we recruited 20 patients diagnosed with Allergic Fungal Rhinosinusitis (AFRS) From the E.N.T outpatient clinic of Minia University Hospital. Patients received oral systemic Itraconazole for 6 weeks after endoscopic sinus surgery.

Results: There is a marked statistically significant difference found between the pre-operative and the post-operative Endoscopic staging score of Lund Kennedy (p=0.001). The median staging before the treatment with itraconazole was 8 which changed to 3 after the treatment & the pre-operative and post-operative CT Lund-Mackay scores demonstrate a difference that is statistically significant (p<0.01). The median score was 13 preoperatively which changed to 6 postoperatively.

Conclusions: In conclusion, our findings indicated that using Systemic Itraconazole significantly reduced the radiologic and endoscopic staging in AFRS patients. Notably, A highly statistically significant improvement in CT and Endoscopic findings after treatment compared to before, underscoring the potential benefit of Itraconazole in addressing AFRS after endoscopic sinus surgery.

Keywords: Itraconazole,FESS, Endoscopic, Radiologic, Allergic fungal sinusitis.

Keywords