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Bruce R. Benton RN Ortho / Neuro
over 6 years agoDecember 27, 2015
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I recall reading quite some time ago that the Mayo Clinic had "linked" many cases of chronic sinusitis with an immune reaction to fungi in the nose / sinuses. (See below) - This seems to have been supported by more recent evidence from a sinus center in Europe (Austria) as well. 

I can see how balloon sinuplasty would mitigate the symptoms of sinusitis - which definitely is important to the sufferers , but wonder what (anti-fungal) treatments might be available to stop the cause of the inflammation to begin with...?

"Many studies at Mayo Clinic have added evidence to the thinking that chronic rhinosinusitis is caused by an immune reaction to fungi in the nose. Our original study linking chronic rhinosinusitis to fungi in the nose, which was published in the Mayo Clinic Proceedings in September 1999, has been reproduced and confirmed by a sinus center in Europe (ENT University Hospital in Graz, Austria).

There are currently 16 studies at Mayo Clinic Rochester to further investigate the role of fungi in inflammatory diseases of the respiratory tract."

Thank you - Bruce Benton RN
Richard Huffaker D.O.
over 6 years agoJanuary 16, 2016
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Hello Bruce, thank you for your comment. 
Fungus is something that we are exposed to on a daily basis.  As a matter fact, we inhale 100s of spores on a daily basis.  Most commonly which are of the Aspergillus species.  The amount of spores are increased usually in the wintertime when it is wet, especially here in Southern Oregon.
For some patients, fungus or mold is a life-threatening illness.  These people are usually immunocompromised from either diabetes or organ transplant or other diseases such as lupus or rheumatoid arthritis.  Most the time when we are immunocompetent body does a great job at eradicating the spores we inhale.
 Back in the 1980s and 90s, there were several articles suggesting that fungus was related to chronic sinusitis.  The studies had some flaws and were difficult to replicate.  The thought behind them was that even after surgery patients have chronic sinusitis.  We have since learned that there is more of a component of biofilm buildup which attributes more to the chronicity of disease rather than a fungal element.  The bacteria pseudomonas has been found to be one of the biggest culprits. 

Those people that do have problems with fungus such as allergic fungal sinusitis or maxillary mycetoma, which both have fungal elements, do well with both allergy testing and treatment and nasal sinus washes with antifungal solution.  Most of these problems however, are not alleviated with balloon sinuplasty and require a more traditional approach with removal of polyps and fungal elements.

Thank you again for your comments.  Let me know if you have any other questions or concerns.
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