Nasal douches are more effective in distributing irrigation solution to the maxillary sinus and frontal recess. This should be the method of choice for irrigating these areas.

These results support the possibility that a neural reflex exists between the esophagus and the paranasal sinuses via the vagus nerve. If indeed present, the reflex-mediated rhinitis derived from this neuropathic inflammation may contribute to the development of CRS in patients with GER. Further study is required to define the relationship between GER and CRS.

Acid reflux into the nasopharynx is a rare event in patients with chronic sinusitis even though a significant proportion (32.4%) have abnormal 24 hour pH studies. It is likely that alternative mechanisms other than direct acid contact are involved in the pathogenesis of chronic sinusitis.

Performing a powered turbinoplasty leads to decreased patient morbidity during the postoperative healing and to a better control of long-term results when compared with submucosal cauterization.