Non-invasive antromycosis: (diagnosis and treatment)

Increasing numbers of cases of chronic maxillary sinusitis are encountered which resist frequent sinus irrigation and treatment of predisposing factors. The antral washouts are of unusual consistencies and colours. The antral washouts of six cases were investigated by culture and microscopic examination and proved to contain fungal colonies. Antroscopy was a valuable asset in diagnosis. One patient had a Caldwell-Luc operation and daily irrigation through an indwelling polythene tube followed by daily instillation of clotrimazole (Canesten). The five patients who refused operation were treated by repeated bi-weekly antral washouts followed by instillation of clotrimazole. Weekly samples of antral secretions were examined by culture and microscopic examination until they were free for four consecutive weeks. We believe that frequent antral irrigation and local instillation of a broad-spectrum antimycotic drug--preferably after debridement--is the treatment of choice for antromycosis.