Recurrence of allergic fungal rhinosinusitis after endoscopic sinus surgery: A retrospective comparative study between nasal and oral steroids

Allergic fungal rhinosinusitis (AFRS) is a highly recurrent form of chronic allergic rhinosinusitis in immunocompetent patients. This study aims to compare the recurrence rates of AFRS between patients who received nasal steroid spray alone and patients who received a combination of nasal and oral steroids after endoscopic sinus surgery. This was a retrospective chart review of patients who underwent endoscopic sinus surgery for AFRS. The selection of the 39 participants has followed the 5 aspects of Bent and Kuhn criteria. Patients were divided into 2 groups: those discharged on both nasal and oral steroids (combination group) and those discharged on nasal steroids alone (local therapy group). All patients were followed for 3 years post operatively, and multiple assessments done for disease recurrence. One patient from 13 patients in the combination therapy group (7.7 %) and 9 patients from the 26 patients in the local therapy group (34.6 %) had recurrence of the condition and underwent functional endoscopic sinus surgery revision surgery (Fisher Exact Test = 3.30, P = .069). AFRS has recurred more frequently among patients who had bilateral disease (33.3%) compared to those who had unilateral disease (0%) (Fisher Exact Test = 4.03, P value = .045). In the postoperative medical management in ARFS, the combination of a short course of oral prednisolone and nasal steroid spray maybe effective to lower the recurrence rate of the disease when compared to nasal steroid spray alone.