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Manuka Honey Sinus Irrigation Versus Systemic Itraconazole in Allergic Fungal Rhinosinusitis: Randomised Clinical
Khalaf Hamead1, Mostafa Ismail1, Abdelrahim A Abdelkarim1
1Department of Otorhinolaryngology, Faculty of Medicine, Minia University, Minya, Egypt.
Background:
Allergic fungal rhinosinusitis (AFRS) is a persistent sinus condition caused by fungal allergies. Endoscopic sinus surgery (ESS) and postoperative systematic and local medical therapies are the most common treatment protocols. Although oral antifungals such as itraconazole are frequently utilised postoperatively, there is increasing interest in alternate therapies that exhibit fewer systemic adverse effects. Manuka honey, recognised for its powerful antibacterial, antifungal and anti-inflammatory characteristics, is a promising alternative. The aim of this study was to assess the efficacy of Manuka honey sinus irrigation in comparison with oral itraconazole for the postoperative management of AFRS.
Methods:
Thirty patients diagnosed with AFRS were recruited for the current randomised clinical trial after ESS. Patients in the two groups randomly received either oral itraconazole (Group A) or Manuka honey sinus irrigation (Group B) for 6 weeks postoperatively. Both cohorts were monitored for 6 months postoperatively.
Results:
Lund-Kennedy endoscopic scores, total IgE levels and SNOT-22 scores were significantly improved in Group B after Manuka honey sinus irrigation. Both groups had similar Lund-Mackay radiological scores and numbers of postoperative sinus infections during the follow-up period.
Conclusions:
Postoperative Manuka honey sinus irrigation is more effective than oral itraconazole for reducing symptoms and preventing the recurrence of AFRS. It is considered a promising therapeutic alternative in the postoperative management of AFRS.
Insights
Manuka honey sinus irrigation significantly improved allergic fungal rhinosinusitis (AFRS) symptoms post-surgery compared to oral itraconazole. This natural therapy offers a promising alternative for AFRS management.
Area of Science:
- Otolaryngology
- Allergy Immunology
- Medical Mycology
Background:
- Allergic fungal rhinosinusitis (AFRS) is a chronic sinus condition linked to fungal allergies.
- Current treatments include endoscopic sinus surgery (ESS) with medical therapies, often involving oral antifungals.
- There is a need for alternative therapies with fewer systemic side effects.
Purpose of the Study:
- To evaluate the effectiveness of Manuka honey sinus irrigation versus oral itraconazole for postoperative AFRS management.
- To compare Manuka honey's efficacy against a standard antifungal treatment.
Main Methods:
- A randomized clinical trial involved 30 patients diagnosed with AFRS post-ESS.
- Patients received either oral itraconazole or Manuka honey sinus irrigation for 6 weeks.
- Outcomes were monitored for 6 months.
Main Results:
- Manuka honey irrigation led to significant improvements in endoscopic scores, IgE levels, and SNOT-22 scores.
- Radiological scores and infection rates were comparable between groups.
- No significant difference in Lund-Mackay radiological scores or postoperative sinus infections was observed.
Conclusions:
- Postoperative Manuka honey sinus irrigation is more effective than oral itraconazole in managing AFRS.
- It shows promise for reducing symptoms and preventing recurrence.
- Manuka honey represents a viable alternative therapeutic option for AFRS.