Efficacy of Different Modalities in Treatment of Different Types of Fungal Sinusitis | ||
| Egyptian Journal of Ear, Nose, Throat and Allied Sciences | ||
| Article 42, Volume 23, Issue 23, January 2022, Pages 1-12 PDF (1.02 M) | ||
| Document Type: Review article | ||
| DOI: 10.21608/ejentas.2022.46414.1427 | ||
| Authors | ||
| Mohammed Aleem* 1; Abdel Hamid Nashar1; Waleed Ezzat1; Mohammed Al-Shahat2 | ||
| 1ORL department, Faculty of medicine, Ainshams unversity- Egypt | ||
| 2Mataria Teaching Hospital- Cairo-Egypt | ||
| Abstract | ||
| Background: Fungal rhinosinusitis (FRS) includes a spectrum of disease processes that vary in clinical presentation, histologic appearances, and treatment options. Objective: This systematic review was done to reach the effective and safe method in management of FRS. Patients and Methods: Meta-analysis was performed in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This study used the published articles (from Jan1985 to Jan2018) in treatment of FRS via search in several databases. Results: Finally, forty-five studies were included in this study. Fifteen of them assessed the treatment of fungal ball (FB) using mainly the functional endoscopic sinus surgery (FESS) the success rate was 98.1%. Twenty included studies have evaluated the management of allergic fungal sinusitis (AFS) via FESS, Systemic steroids, Antifungals and immunotherapy. The results showed that FESS represents the first-line, followed by aggressive medical therapies, the recurrence rate after postoperative steroids was 20.6%, postoperative antifungals was 40% and after immunotherapy was 9.1%. Ten included studies considered the Invasive Fungal sinusitis. The results showed that the combination of systematic antifungal therapy and aggressive surgical debridement was the treatment of the choice. Conclusion: FESS is the treatment of choice for FB. AFS treatment consists of surgical extirpation of the allergic mucin and followed by anti-fungal therapy, Immunotherapy, and corticosteroids. Treatment of invasive fungal sinusitis includes surgical resection of necrotic tissues, systemic antifungal therapy and reversal of immune dysfunction | ||
| Keywords | ||
| Allergic fungal rhinosinusitis; antifungal in AFS; aspergillus in FB; fungus ball rhinosinusitis; immunotherapy in AFS; invasive fungal rhinosinusitis | ||
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