Innocuous Fungi Is Gaining Greater Acceptance As Cause Of Chronic Sinusitis

Sinusitis, inflammation of the sinus passages around the nose and throat, is one of the most common illnesses in the United States, affecting between 30 and 40 million people each year, and triggering between 18 and 22 million doctor visits.

Among the symptoms are nasal congestion, thick mucus production, headaches, tenderness in the face, and aching behind the eyes. Chronic sinusitis persists for weeks, months, or longer, causing misery for sufferers. In the most severe cases the sinus cavity clogs, preventing drainage of mucous and making it difficult to breathe through the nose.

In the past, the prevailing opinion among the healthcare community was that upper respiratory infections such as colds and flu caused chronic sinusitis by damaging the upper respiratory epithelium. Within the last decade, physicians at the Mayo Clinic hypothesized that most cases of chronic sinusitis were caused not by epithelial dysfunction, but by an inflammatory reaction to the presence of fungi in the mucus. This novel idea was initially rejected by medical specialists, but in a few short years, evidence in favor of the fungal etiology of chronic sinusitis has accumulated. Surveys of ear, nose, and throat specialists (ENTs, also known as otolaryngologists) and allergists revealed that a large number of the specialists treating this disease have adopted the theory that an inflammatory response to fungus in susceptible patients (almost 10%) is the cause of Chronic Sinusitis.

During this year's American College of Allergy, Asthma and Immunology symposium. The results of three surveys revealed that prevailing perceptions among ENT's regarding the possible fungal cause of chronic sinusitis, especially for patients who do not benefit from surgery to correct chronic sinusitis. This group of patients is classified as "surgery refractory."