Efficacy of Post-Operative Oral Prednisolone for the Control of Disease in Allergic Fungal Sinusitis

Abstract

Background: Ambiguity persists regarding the dosage, frequency, and duration for the use of oral steroids in Allergic Fungal Sinusitis (AFS). Objective: To assess the efficacy of post-operative oral steroid (prednisolone) for the control of disease in Allergic Fungal Sinusitis. Methodology: This was a comparative study, conducted at Bahawal Victoria Hospital, Bahawalpur from January 2019 to March 2019. A total of 40 patients, aged 18 or above with weight over 50 kilograms, having proved Allergic Fungal Sinusitis (AFS) as per criteria defined by Deshazo and Swain, were recruited for this study. All the patients were enrolled within 14 days of excisive sinus surgery adopting endoscopic sinus surgery with or without open methods. Group A (n=20) received oral steroids while Group B (n=20) received a placebo. Patients of both groups also used fluticasone nasal spray and oral itraconazole. Evaluation of all the patients was done at the time of enrollment, 6 and 12 weeks. Data were analyzed by SPSS version 21. Results: Out of a total of 40 patients, 17 (42.5%) were males. After 6 weeks of continuous therapy in both the study groups, 14 (70%) patients of Group A showed complete relief of symptoms in comparison to none in Group B (p-value = 0.001). After 12 weeks of therapy having tapering off in both study groups, all patients in Group A had complete relief of symptoms in comparison to only one (5%) in Group B (p-value = 0.001). Conclusion: Oral steroids of prednisolone, along with inhaled steroids therapy for a minimum of 12 weeks after excisive sinus surgery were found efficacious for the control of disease in patients with Allergic Fungal Sinusitis.