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December 1996

Allergic Fungal Sinusitis in the Pediatric Population

Author Affiliations

From the Division of Otolaryngology, Medical College of Georgia, Augusta.

Arch Otolaryngol Head Neck Surg. 1996;122(12):1381-1384. doi:10.1001/archotol.1996.01890240087019

Objective:  To determine the optimal treatment in pediatric patients with allergic fungal sinusitis (AFS).

Design:  A retrospective review of 10 patients diagnosed as having AFS.

Setting:  Academic tertiary medical center.

Patients:  Pediatric patients who fulfilled 5 criteria necessary for diagnosis of AFS: (1) type 1 hypersensitivity; (2) nasal polyposis; (3) characteristic computed tomographic scan; (4) histological evidence of eosinophilic mucus without evidence of fungal invasion into sinus tissue; and (5) a positive fungal stain or culture of sinus contents.

Treatment:  All patients were treated with functional endoscopic sinus surgery with removal of fungal debris. Adjuvant therapy included nasal irrigations, postoperative endoscopic cleanings, and systemic corticosteroids in 9 of 10 patients.

Mean Outcome Measure:  Clinical disease monitored endoscopically by means of an objective staging system.

Results:  Five patients were without disease (stage 0), 1 had allergic mucin and mucosal edema (stage I), 1 had allergic mucin and polypoid edema (stage II), and 3 had polyps and/or fungal debris (stage III).

Conclusions:  The treatment and prognosis of pediatric AFS are similar to those of adult AFS. However, systemic corticosteroids should be weaned aggressively in children to minimize complications, particularly long-term growth retardation.Arch Otolaryngol Head Neck Surg. 1996;122:1381-1384

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