Nasal amphotericin irrigation in chronic rhinosinusitis

Current Opinion in Otolaryngology & Head and Neck Surgery
James A StankiewiczJoseph M Scianna

Abstract

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

References

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Citations

Dec 19, 2012·Current Allergy and Asthma Reports·Kathleen T Montone
Jun 1, 2014·Archives of Pathology & Laboratory Medicine·Kathleen T Montone
Apr 26, 2012·The Laryngoscope·Andrew H MurrStephen J Vesper
Sep 21, 2013·Expert Opinion on Pharmacotherapy·Gwijde F J P M Adriaensen, Wytske J Fokkens
Feb 24, 2015·Brazilian Journal of Otorhinolaryngology·Wilma T Anselmo-LimaShirley Shizue Nagata Pignatari
Jun 23, 2016·Otolaryngologic Clinics of North America·Maheep SohalSeth M Brown
Nov 27, 2009·Postgraduate Medicine·Bradley F MarpleUNKNOWN American Academy of Otolaryngic Allergy Working Group on Chronic Rhinosinusitis
Jan 2, 2013·Current Opinion in Otolaryngology & Head and Neck Surgery·Alice Huang, Satish Govindaraj
Nov 3, 2009·Immunology and Allergy Clinics of North America·Arthur W WuNeil Bhattacharyya
Jan 15, 2011·Current Opinion in Otolaryngology & Head and Neck Surgery

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