“Allergic sinusitis” revisited

Chronic sinusitis pathophysiology: The role of allergy

“…27 However, more recent and more comprehensive studies by the same group have not been able to confirm this finding using single-photon emission computed tomography, indium, or positron emission tomography imaging of the sinuses, suggesting that seasonal allergen exposure alone does not drive or exacerbate sinus disease. 28 In contrast, another recent study did show increased eosinophilia in the maxillary sinuses of allergic subjects during the season of exposure. 29 …”

Chronic rhinosinusitis phenotypes

“…In early pilot studies, it was reported that increased metabolic activity could be detected in the sinuses during relevant seasonal allergy exposures. But when these studies were stringently followed-up using multiple methods to demonstrate seasonally-associated increased inflammation in the sinuses (using SPECT imaging, Indium 111 -labeled leukocyte uptake, and PET scanning) the results were categorically negative 49 . There has been one well-performed study that did identify seasonal exacerbations of CRS (figure 4), however in this study, the “season” where worsening occurred was winter and the worsening could only be ascribed to viral respiratory infections without any contribution observed during actual allergy seasons 50 .…”

Nasal challenge with allergen leads to maxillary sinus inflammation

“…8,9 By using computed tomographic scans, sinusitis has been demonstrated in allergic patients in some studies 10,11 but not others. 12 Although these studies are limited by referral-pattern biases and retrospective data collection, they nevertheless suggest a significant clinical association between allergic rhinitis and chronic rhinosinusitis. A mouse model of acute sinusitis and allergic rhinitis has also supported this relationship.…”