Abstract
A great deal of data supports an association between chronic sinusitis and asthma. We have developed a better understanding of the pathogenesis of sinus disease in asthmatic patients and now realize that eosinophilic sinus infiltration plays a direct role in chronic mucosal inflammation that may predispose the paranasal sinuses to recurrent or chronic bacterial infection. Although the mechanisms that link sinusitis and lower airways disease remain incompletely understood, activation of neural reflexes may result in increased bronchial responsiveness. Blinded, placebo-controlled trials with long-term follow-up need to be completed before we can reliably predict the effect of sinus therapy on clinical parameters of asthma. Until then, we recommend that sinus disease be considered in all patients with moderately severe asthma and treated aggressively when it is identified.
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