ABSTRACT
Chronic Sinusitis Chronic sinusitis is defined as persistent inflammation of the sinuses at least 4 weeks after initiating appropriate therapy. The sinuses are characterized by inflammatory thickening and polypoid changes of the mucosa. Marked tissue eosinophilia is present. Whether bacte rial infection is important in the pathogenesis of chronic sinusitis is not established. In patients who fail medical therapy with antibiotics, corticosteroids, and decongestants and, when indicated, allergen control, surgery should be considered. Surgery is also indicated in sinus disease for large obstructing polyps, a suspicion of tumor, mucocele or pyocele, fungal sinusitis and when the sinusitis is complicated by brain abscess, meningitis, cavern ous sinus thrombosis, or subdural empyema.
