Introduction:
Allergic Fungal Rhinosinusitis (AFRS) is a type I and type III mediated hypersensitivity reaction to inhaled fungal antigens, notably Aspergillus species and dematiaceous fungi present in the nasal cavity of immunocompetent individuals.1This non-invasive form of fungal sinusitis is notorious for high recurrence rates and is often a topic of intrigue to the treating clinician. Multimodality treatment with primary surgery followed by medical management is the usual norm. The aim of surgery in these cases is to remove the antigenic fungal load and improve the aeration of sinuses. Surgery would facilitate easy access to topical sprays and lavages. Medical therapy with topical and systemic corticosteroids plays a vital role in preventing disease recurrence. However, a steroid-sparing agent with a better side effect profile may be a welcome alternative. The favorable outcomes in patients with Allergic Broncho Pulmonary Aspergillosis(ABPA) treated with Itraconazole have prompted rhinologists to add Itraconazole to the armamentarium against AFRS.2, 3 However, there is a paucity of studies comparing the effectiveness of Itraconazole and systemic steroids as an adjuvant to topical steroids in post-operative patients, in preventing disease recurrence in AFRS, which was the objective of our study.