Effectiveness of Kupferberg Classification based treatment protocol in Post Operative Management of Allergic Fungal Rhinosinusitis

AIM OF THE STUDY: To find the usefulness of a treatment protocol based on Kupferberg classification in the post operative management of AFRS. OBJECTIVES: To know the appropriate dose of steroid to achieve endoscopic grade 0 and to know the most common fungus causing AFRS MATERIALS AND METHODS: This was a prospective study consisting of 19 patients of AFRS who satisfied inclusion criteria. Endoscopy, CT of the paranasal sinuses and SNOT-22 scoring was done pre operatively. Patients underwent FESS for AFRS and were followed up at regular intervals. At each visit Kupferberg grading of the nasal cavity was done and was treated according to the stage. At the end of 6 months SNOT-22 scoring was done. Clinical photographs of the endoscopic findings were recorded and the data was analysed RESULTS: Steroid saline wash and Oral pulse steroid therapy were effective in decreasing the endoscopic grade. Improvement in SNOT-22 score was statistically significant at the end of 6 months. Ethmoid sinus was the most commonly involved sinus in AFRS. Aspergillus was the most common isolate in our study. CONCLUSION: Steroid saline wash and short bursts of systemic steroids were effective in control of the disease with the added advantage of no complications associated with long term oral corticosteroid therapy