الفهرس | Only 14 pages are availabe for public view |
Abstract The pathophysiology of rhino sinusitis is multifactorial. However, regardless of etiology, the common basis for the development of sinus disease is often associated with mucous stasis due to ostiomeatal obstruction and/or mucociliary dysfunction. Persistent obstruction results in decreased oxygen tension, reduced sinus pH, ciliary dysfunction, and negative pressure within the sinus cavity. Sneezing or nose blowing may cause a transient opening of the sinus drainage pathways. This, in addition to negative pressure within the sinus cavity, may result in the inoculation of pathogenic bacteria from the nasal cavity or nasopharynx into the sinus cavity. (٢٠, ٢١) An optimal environment for overgrowth is thereby achieved, resulting in rhino sinusitis. There has been a great interest in identifying pathways for the development of rhino sinusitis. The inflammatory roles of bacteria and fungi, and the subsequent response by inflammatory cells and production of mediators of inflammation have generated new thinking regarding the pathophysiology. A noninfectious inflammatory response as a result of bacterial or fungal colonization resembling ‘‘allergic or asthmatic’’ inflammation has been described. The host inflammatory response with production of inflammatory cytokines may be the underlying cause of rhino sinusitis. Of particular interest in this area are the role of bacterial, fungal allergy, eosinophilic inflammation, biofilms, and superantigens. (٢٠, ٢١) |