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.