Efficacy of voriconazole in nonsurgical treatment of allergic and chronic granulomatous fungal rhinosinusitis: a preliminary study

Hesham M El-Adl, Mohamed Abd El-Badee Awad, Shawky Mahmoud El-Morsy, Yasser W Khafagy

The Egyptian Journal of Otolaryngology 2018 34(1):15-20

Objective Evaluate the effectiveness and safety of voriconazole in the non surgical treatment of allergic fungal rhinosinustis (AFRS) and chronic granulomatous fungal rhinosinusitis (CGFRS). Also, we present our conservative approach for cases of chronic granulomatous fungal rhinosinusitis with skull base involvement. Patients and Methods 26 Patients with the diagnosis of AFRS (17 patients) and CGFRS (9 patients) have been treated with voriconazole for a period of 3 weeks in AFRS to three months in CGFRS. Results All patients with AFRS have shown marked improvement both clinically and radiologically, recurrence occur in 6 cases, two patients improved medically, and 4 patient required endoscopic sinus surgery. From 9 patients with CGFRS, 6 patients improved completely and did not require surgery, three patients had persistent or residual disease and required surgical interference. Conclusions Voriconazole is effective, and safe in treatment of AFRS as well as CGFRS. This is a preliminary study; further long-term studies are required for proper understanding of the strategies of this new treatment in fungal rhinosinusitis management.

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