Causes of Rhinosinusitis

Current theories about the etiology of chronic rhinosinusitis are many, including:

• A cell-mediated (non-allergic) eosinophilic reaction to Alternaria, a comnon fungus. This theory is being proposed by the Mayo Clinic. Read more on our Fungal Rhinosinusitis page or at www.sinuseducation.org.
• Chronic infection with Staph Aureus (a bacteria which sectretes a toxin) and the development of a "Super Antigen" or diffuse inflammatory response. Chronic osteitis or osteomyelitis may be a cause.
• Both bacteria and fungi protect themselves in a "biofilm", making it nearly impossible to eradicate them with medical therapy alone.
• IgE-mediated allergies undoubtably play a major role.

Unfortunately, the reality may be that all of these mechanisms exist and may play varying roles in varying patients. We need to be extremely diligent in seeking out the etiology as this will affect our treatment plan.