Allergic fungal sinusitis: clinical aspects and treatment outcome

To highlight the clinical approach to patients with allergic fungal sinusitis and describe our surgical technique to enhance access and minimize recurrence among these patients. Retrospective analysis of the clinical characteristics and treatment outcome of 20 patients with AFS managed by the author over a 6- year period. Full history taking, complete endoscopic evaluation, CT scan of the paranasal sinuses and histopathological evaluation of the retrieved allergic mucin were done in all cases. The patients were 8 males and 12 females, 10 to 60 years. All patients were subjected to endoscopic sinus surgery followed by meticulous follow up and steroid therapy. Follow-up ranged between 2 - 65 months. At the last follow up visit, 12 patients had endoscopically well healed cavities with no evidence of disease. Seven patients had revision surgery during the follow up period. Allergic mucin is the most consistent feature of AFS. The cornerstone of management is ample and lasting drainage of the affected areas followed by topical and systemic steroids. Long term endoscopic surveillance is mandatory to detect and manage early recurrence