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− | Several types of source can cause [[rhinosinusitis]] | + | Several types of source can cause [[rhinosinusitis]]. The problems can last only a short time, termed ''acute rhinosinusitis'', or they can last for months of even years, called ''chronic rhinosinusitis''. Different causes are susceptible to different [[treatments]]. |
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==Environmental== | ==Environmental== | ||
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===Substances=== | ===Substances=== | ||
− | Substances can directly interfere with sinus function, or trigger harmful bodily response | + | Substances can directly interfere with sinus function, or trigger harmful bodily response |
* Viruses such as the common cold do not respond to antibacterial therapy. They usually result only in acute rhinosinusitis, however complications can lead to chronic [[rhinosinusitis]]. | * Viruses such as the common cold do not respond to antibacterial therapy. They usually result only in acute rhinosinusitis, however complications can lead to chronic [[rhinosinusitis]]. | ||
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** Pollen. | ** Pollen. | ||
** Pollution. Air pollutants can cause sinus inflammation. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251962/] | ** Pollution. Air pollutants can cause sinus inflammation. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251962/] | ||
− | * | + | * Substances in food could contribute to rhinosinusitis, whether through allergic or non-allergic reactions. |
** Common food allergies that can induce rhinosinusitis include dairy, peanuts, tree nuts, wheat, and other grains. An elimination diet, in which the person eats a simple diet, can reveal possible allergens. | ** Common food allergies that can induce rhinosinusitis include dairy, peanuts, tree nuts, wheat, and other grains. An elimination diet, in which the person eats a simple diet, can reveal possible allergens. | ||
** Alcohol can potentially aggravate sinus issues. | ** Alcohol can potentially aggravate sinus issues. | ||
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* High temperature, and dew point could contribute to sinus symptoms. | * High temperature, and dew point could contribute to sinus symptoms. | ||
* Low visibility could indicate weather conducive to sinus symptoms. | * Low visibility could indicate weather conducive to sinus symptoms. | ||
− | * High wind could rapidly introduce different weather conditions, affecting sinus symptoms | + | * High wind could rapidly introduce different weather conditions, affecting sinus symptoms. |
* The relationships between weather and sinus symptoms can be quite complex. At times, a weather component can track strongly ''with'' symptoms, at other times strongly ''against''. | * The relationships between weather and sinus symptoms can be quite complex. At times, a weather component can track strongly ''with'' symptoms, at other times strongly ''against''. | ||
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[[File:Female human evolution 2.png|thumb|Humans evolved such that an upright posture and a large forebrain apply unusual pressures on the sinuses.]] | [[File:Female human evolution 2.png|thumb|Humans evolved such that an upright posture and a large forebrain apply unusual pressures on the sinuses.]] | ||
− | People are born with a set of genetic coding that can predispose | + | People are born with a set of genetic coding that can predispose the person towards rhinosinusitis. Additional biological developments throughout the course of life can cause sinus issues. |
Humans evolved such that an upright posture and a large forebrain apply unusual pressures on the sinuses. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266099/] This development may have happened too fast for the sinuses to rebalance appropriately, explaining the large number and severity of sinus issues. | Humans evolved such that an upright posture and a large forebrain apply unusual pressures on the sinuses. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266099/] This development may have happened too fast for the sinuses to rebalance appropriately, explaining the large number and severity of sinus issues. | ||
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Traditionally, blockage of maxillary ostia (sinus openings into the nose) have been seen as leading to congestion and sinusitis. The maxillary ostia are located high up the sinuses, preventing gravity from clearing the sinuses, and requiring the cilia (clearing hairs) to do more work. This results in less effective clearance. More recent research has found that blockage of the nostrils can also lead to sinusitis. As air flows more freely through the nose and sinuses, it assists in clearing mucus. | Traditionally, blockage of maxillary ostia (sinus openings into the nose) have been seen as leading to congestion and sinusitis. The maxillary ostia are located high up the sinuses, preventing gravity from clearing the sinuses, and requiring the cilia (clearing hairs) to do more work. This results in less effective clearance. More recent research has found that blockage of the nostrils can also lead to sinusitis. As air flows more freely through the nose and sinuses, it assists in clearing mucus. | ||
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New research investigates the specific biological mechanisms underlying cases of chronic rhinosinustis. [https://www.ncbi.nlm.nih.gov/pubmed/27393777] This process of ''endotyping'' includes particular molecules and cells, such as T helper cells. | New research investigates the specific biological mechanisms underlying cases of chronic rhinosinustis. [https://www.ncbi.nlm.nih.gov/pubmed/27393777] This process of ''endotyping'' includes particular molecules and cells, such as T helper cells. | ||
− | <blockquote>Experts agree that the elevation of these inflammatory endpoints may be the result of maladaptive immune signaling, triggered | + | <blockquote>Experts agree that the elevation of these inflammatory endpoints may be the result of maladaptive immune signaling, triggered by impaired mucociliary function and epithelial cell barrier breakdown. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204709]</blockquote> |
<blockquote>CRS is due to dysregulated immunologic responses to external stimuli, which induces inflammatory mediators. [https://www.ncbi.nlm.nih.gov/pubmed/30507689]</blockquote> | <blockquote>CRS is due to dysregulated immunologic responses to external stimuli, which induces inflammatory mediators. [https://www.ncbi.nlm.nih.gov/pubmed/30507689]</blockquote> |