Nasal amphotericin irrigation in chronic rhinosinusitis.
OBJECTIVE
To review the literature on the use of amphotericin irrigation for the treatment of chronic rhinosinusitis.


RESULTS
Although the etiology of acute rhinosinusitis is usually bacterial in nature, the exact etiology of chronic rhinosinusitis is unclear. Recent literature reports pointed to fungal colonization as a likely pathogenesis. It was hypothesized that a nonallergic eosinophilic immunoglobulin response to these fungi by the host was the cause of the symptoms, not a fungal invasion into the mucosa. The paper reviews the most recent articles investigating the use of amphotericin irrigation, as well as sprays and oral medications, of the nasal and sinus mucosa in patients with chronic rhinosinusitis.


CONCLUSIONS
The use of amphotericin for patients with chronic rhinosinusitis is not substantiated by the majority of publications. Although some studies found improvement on radiographic images, the symptoms of the disorder were not improved even with fungal eradication. Further studies need to be carried out to determine if changes in dosage, treatment time or route of administration could improve results.
Stankiewicz
James A
JA
Department of Otolaryngology - Head & Neck Surgery, Loyola University of Chicago Stritch School of Medicine, Maywood, Illinois 60153, USA. jstank@lumc.edu
Musgrave
Brandon K
BK
Scianna
Joseph M
JM
D000281:Administration, Intranasal; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*; D012220:Rhinitis / Q000188:drug therapy* / Q000382:microbiology*; D012852:Sinusitis / Q000188:drug therapy* / Q000382:microbiology*; D007507:Therapeutic Irrigation
D000935:Antifungal Agents; D000666:Amphotericin B