ABSTRACT
INTRODUCTION Determination of Important Factors A host of factors influence the development and pathogenesis of chronic rhinosinusitis (CRS) (1,2). Although these factors have been suggested based on clinical observations and, in some circumstances, have been studied experimentally, there is a paucity of knowledge of how or even whether these factors have any bearing on the disease. We can consider existing data by using the framework of Koch’s postulates by first examining epidemiologic evidence: what factors are associated with CRS? Second, is there a plausible mechanism to explain the factor’s role in either the etiology or the pathophysiology of CRS? And third, does alteration of the proposed factor cause a change in disease expression: what is the response to treatment? These critical questions are difficult to answer in the current state of CRS research, but to achieve progress in this field, we must attack this problem by using this mindset.
