Abstract: . . .  Pulmonary aspiration of nasal secretions in patients with chronic sinusitis and asthma. Arch Otolaryngol Head Neck Surg 2003; 129:10061009. 13. Griffin MP, McFadden ER, Ingram RH. Airway cooling in asthmatic and nonasthmatic subjects during nasal and oral breathing. J Allergy Clin Immunol 1982; 69:354359. 14. Ponikau JU, Sherris DA, Kephart GM, Kern EB, Gaffey TA, Tarara JE. Features of airway remodeling and eosinophilic inflammation in chronic rhinosinusitis: is the histopathology similar to asthma? J Allergy Clin Immunol 2003; 112:877882. 15. Bucca C, Rolla G, Scappaticci E, et al. Extrathoracic and intrathoracic airway responsiveness in sinusitis. J Allergy Clin Immunol 1995; 95:5259. 16. Rachelefsky GS, Katz RM, Siegel SC. Chronic sinus disease with associ- ated reactive airway disease in children. Pediatrics 1984; 73:526529. 17. Slavin RG. Relationship of nasal disease and sinusitis to bronchial . . .
. . .  In chronic sinusitis, the same organ- isms are involved, plus Staphylococcus aureus, coagulase-negative Staphylococcus species, and anaerobic bacteria. These organisms are becoming resistant to antibiotics. For example, the reported rates of resistance to penicillin in S pneumoniae across the United States are 28% to 44%. 4 Resistant organisms are more common in patients who have received two or more recent courses of antibiotics, a common scenario in patients with chronic sinusitis. Allergic fungal sinusitis is a distinct condition Allergic fungal sinusitis is a distinct condition that occurs in nonimmunocompromised patients. 5 Fungi are ubiquitous in the environ- ment, and most people tolerate exposure to mold spores in the air. However, people with allergic fungal sinusitis have a hypersensitivity reaction involving an intense eosinophilic . . .
. . .  treatment includes avoidance of aspirin and nonsteroidal anti-inflammatory drugs (or desensitization protocols if aspirin therapy is necessary) and nasal steroids to shrink polyps. ANY HAVE COLDS , but few need antibi- otics. This is a good adage, but never- theless some patients do develop bacterial sinusitis and would benefit from antibiotic treatment. Furthermore, there is a link, often unappreciated, between sinusitis, asthma, and aspirin, and treating the sinusitis (and avoid- ing aspirin) might improve the asthma. Complicating matters, some cases of chronic sinusitis are due to an allergy to fungi coloniz- ing the sinuses. SINUSITIS IS INFLAMMATION Sinusitis is defined as inflammation of the usu- ally air-filled sinuses of the skull. The inflam- mation can be caused by infectious (bacterial, viral, or fungal) or noninfectious (allergic) triggers. This inflammation . . .
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