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VOLUME 1 , ISSUE 1 ( September-December, 2009 ) > List of Articles


Medical Therapy for Fungal Rhinosinusitis

Keywords : Amphotericin B,Itraconazole,Voriconazole,Azole,steroids,antifungal

Citation Information : Medical Therapy for Fungal Rhinosinusitis. Int J Otorhinolaryngol Clin 2009; 1 (1):63-68.

DOI: 10.5005/jp-journals-10003-1009

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2009; The Author(s).


Medical therapy forms an important modality in the management of fungal rhinosinusitis. This essentially comprises of topical as well as systemic antifungals, steroids or both, depending upon the nature of the disease. The drugs may need to be started preoperatively in some conditions, but it is essentially the postoperative management which is vital to prevent recurrences, and may sometimes continue for months. Discussed here are the various forms of fungal rhinosinusitis and their proposed regimens.

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  1. Prognosis for Allergic Fungal Sinusitis. Otolaryngol Head Neck Surg 1997;117:35–41.
  2. Allergic Fungal Sinusitis: A four year followup. Am J Rhinol 2000;14:149–56.
  3. A randomised trial of itraconazole in allergic bronchopulmonary Aspergillosis. N Engl J Med 2000;342:756–62.
  4. Anti-inflammatory effect of itraconazole in stable bronchopulmonary Aspergillosis: A randomised controlled trial. J Allergy Clin Immunol 2003;111:952–57.
  5. Medical Treatment of Allergic Fungal Sinusitis. Ann Allergy Asthma Immunol 2000;85:90–101.
  6. Allergic fungal sinusitis in the paediatric population. Arch Otolaryngol Head Neck Surg 1996;122:1381–84.
  7. Allergic Aspergillus Sinusitis with concurrent allergic bronchopulmonary Aspergillosis: Report of a case. J Allergy Clin Immunol 1988;81:844–46.
  8. Fungal rhinosinusitis – state-of-the-art diagnosis and treatment . J Otolaryngol 2005;34(Suppl):S18–S22.
  9. Functional endoscopic sinus surgery and 109 mycetomas of the paranasal sinuses. Laryngoscope 1997;107:112–17.
  10. Fungal Balls of the Paranasal Sinuses. Otolaryngol Clin N Am 2000;33:398–98.
  11. Treatment of allergic fungal sinusitis with high dose itraconazole. Am J Rhinol 2003;17:1–8.
  12. Sodium Chloride treatment of amphotericin B nephrotoxicity: Standard of care. West J Med 1995;162:313–17.
  13. Amphoterecin B: 30 years of clinical experience. Reviews of Infectious Diseases 1990;12:308–29.
  14. Clinical Pharmacology of systemic antifungal agents in clinical use, current ivestgational compounds and putative targets for antifungal drug development. Adv Pharmacol 1998;44:343–501.
  15. Agents for treatment of invasive fungal infections. Otolaryngol Clin N Am 2000;33(2):277–99).
  16. Antifungal agents in the 1990's: current status and future developments. Drugs 1997;53:539–49.
  17. Role of local amphotericin B therapy for sino-orbital fungal infections. Ophthal Plast Reconstr Surg 1999;15(1):28–31.
  18. Intraorbital injection of amphotericin B for palliative treatment of Aspergillus orbital abscess. Ophthal Plast Reconstr Surg 1994;10(4):276–77.
  19. Use of Radio-opaque Intraorbital catheter in the treatment of Sino-Orbital-Cranial Mucormycosis. Arch Ophthalmol 2007;125(12).
  20. Retrobulbar amphotericin B injections for treatment of invasive sino-orbital Aspergillosis. Jpn J Ophthalmol 2007;51(4):309–11.
  21. Use of azoles for systemic antifungal therapy. Adv Pharmacol 1997;39:143–89.
  22. The treatment of Aspergillosis and aspergilloma with itraconazole, clinical results of an open international study (1982-1987). Mycoses 1988;31:476–85.
  23. In vitro determination of optimal antifungal combinations against Cryptococcus neoformans and Candida albicans. Antimicrob Agents Chemother 1995;39:2459–65.
  24. Assessment of the antifungal activity of fluconazole and amphotericin B administered alone, and in combination against Candida albicans by using a dynamic in vitro mycotic model. Antimicrob Agents Chemother 1998;42:1382–86.
  25. Combination therapy in a model of pulmonary Aspergillosis. Mycoses 1991;34:281–85.
  26. Current and emerging azole antifungal agents. Clin Microbiol Rev 1999;12:40–79.
  27. Posaconazole: A broad-spectrum triazole antifungal. Lancet Infect Dis 2005;5:775–85.
  28. Posaconazole is effective as salvage therapy in zygomycosis: A retrospective summary of 91 cases. Clin Infect Dis 2006;42:c61–c65.
  29. Posaconazole treatment for Apohysomyces elegans rhino-orbital zygomycosis following trauma for a male with well-controlled diabetes. Journal of Clinical microbiology 2007;45(5):1648–51.
  30. Rhino-orbitocerebral mucormycoses caused by Apohysomyces elegans. J Clin Microbiol 2006;44(3):892–98.
  31. Novel perspectives on mucormysoses: Pathophysiology, presentation and management. Clin Microbiol Rev 2005;18:556–69.
  32. Rhincerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperaric oxygen therapy. Arch Otolaryngol Head Neck Surg 1988;114:791–94.
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