Abstract
Two main factors are considered to be involved in the pathogenesis of sinusitis: anatomical abnormalities of the human paranasal sinuses, and factors predisposing to inflammation. Inflammation is usually induced by bacterial infections, virus infections or allergic diseases, influenced by the patient and environmental backgrounds. The major causes of inflammation in Japan used to be bacterial and virus infections, manifesting as typical purulent chronic sinusitis. In recent decades, however, eosinophilic chronic rhinosinusitis (ECRS) has come to be identified as the main cause of sinusitis, and it is known to be refractory to treatment.
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