Conditions that lead to chronic or recurrent sinusitis

1. Untreated acute sinusitis that results in damage to the mucous membranes.

2. Chronic medical disorders that cause inflammation in the airways or persistent thickened stagnant mucus. Some of these include diabetes, AIDS or other disorders of the immune system, hypothyroidism, cystic fibrosis, Kartagener's syndrome, and Wegener's granulomatosis.

3. Structural abnormalities.

Abnormalities in the nasal passage can cause blockage increasing the risk for chronic sinusitis. Some include the following:

Deviated septum is a common structural abnormality in which the septum, the center section of the nose, is shifted to one side, usually the left.

Polyps are small benign growths in the nasal passage. Polyps impede mucus drainage and restrict airflow.

Enlarged adenoids. Adenoids are masses of tissue located high on the posterior wall of the pharynx. They are made up of lymphatic tissue, which trap and destroy pathogens in the air that enter the nasopharynx.

Gastroesophageal Reflux Disease. Gastroesophageal acid reflux (GERD), a disorder in which acid backs up from the stomach to the esophagus, has been noted as a risk factor for a number of upper respiratory conditions. It has been associated with sinusitis in children in a number of studies and there is some suggestion that it may play a role in some adult cases of chronic sinusitis. In a 2001 study over 4% of children with GERD had sinusitis, and in a surprising 2000 study 63% of children with chronic sinus problems had GERD. GERD, however, is very normal in children, and some experts believe this association has no significance for sinusitis or any other airway problems.

Asthma and Allergies. Allergies, asthma, and sinusitis often overlap. Those with allergic rhinitis (so-called hay fever and rose fever) often have symptoms of sinusitis, and true sinusitis can develop as a result of the mucus blockage it causes. A causal association, however, has not been proved, and many experts believe allergies themselves rarely predispose to sinusitis.

Severe asthma (which is often associated with allergies) and chronic sinusitis often overlap, although the relationship is unclear. Between 53% and 75% of children with asthma caused by allergies have sinus abnormalities, and various studies have shown that between 17% and 30% of asthmatic patients develop true sinusitis. In fact, chronic sinusitis may actually be the cause of asthma in some cases.