Systemic corticosteroids for allergic fungal rhinosinusitis and chronic rhinosinusitis with nasal polyposis: a comparative study.
OBJECTIVE
To compare the effect of preoperative high-dose systemic corticosteroids on the radiographic and endoscopic appearance of allergic fungal rhinosinusitis (AFRS) and chronic rhinosinusitis with nasal polyposis (CRSwNP).


METHODS
Eight AFRS and 10 CRSwNP patients underwent computed tomographic (CT) scans and then received preoperative 1 mg/kg prednisone for 10 days. CT scans were repeated 1 day before surgery and compared with pretreatment scans (Lund-MacKay radiologic scoring system). The endoscopic appearance was recorded intraoperatively.


RESULTS
The score dropped from 16 (66.4%) to 4.75 in the AFRS group and from 18.4 (23%) to 14.1 in the CRSwNP group (P=0.0064). Intraoperatively, most sinus mucosal surfaces appeared normal in the AFRS patients but were markedly edematous in the CRSwNP patients.


CONCLUSIONS
Radiographic response of AFRS to systemic corticosteroids is significantly greater compared with CRSwNP. This finding is supported by endoscopic observation.
Landsberg
Roee
R
Department of Otolaryngology-Head and Neck Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Israel. jeroy@bezeqint.net
Segev
Yoram
Y
DeRowe
Ari
A
Landau
Tali
T
Khafif
Avi
A
Fliss
Dan M
DM
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009181:Mycoses / Q000188:drug therapy*; D009298:Nasal Polyps / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D012220:Rhinitis / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D012852:Sinusitis / Q000188:drug therapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids; D011241:Prednisone