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Medical Treatment of Chronic Sinusitis in the Immunocompetent and Immunosuppressed Patient: A Review

Chronic sinusitis may arise from a variety of causes. Failure of mucociliary transport, nasal obstruction, and breakdown of the mucosal barrier are important mechanisms that may contribute to irreversible tissue pathologic changes in the paranasal sinuses. Diagnosis is usually made radiographically using plain films, polytomography, or computerized tomography. Medical treatment attacks underlying causes such as allergy or viscous mucus secretions. In addition to antibiotic therapy, management of the underlying medical problems, general prophylactic measures, immunologic reconstitution of specific immune deficiencies, and vaccine therapy when combined with surgical therapy are likely to help improve survival of the immunosuppressed patient with chronic sinusitis.