Talk:Sinusitis

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Sinusitis and Personality Disorders - Mental Illness.[edit]

My research of confirmed research articles confirms a connection between serious forms of deep sinusitis, ie sphenoid, and personality changes, neurological changes, etc...

Here are the links: Nasal, ... PubMed Links

This material is not common knowledge although somewhat simple to understand. An infection close to the brain, and toxins enter it.

--Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 04:56, 8 February 2010 (UTC)

He got banned indefinitely! Gccwang (talk) 06:21, 26 August 2014 (UTC)

Removal of text[edit]

This text

Natural Nasal Sprays such as Sinus Buster, SinuSoothe and Sinol are increasingly being recommended by Health physicians in the U.S. to relieve the symptoms of sinusitis. The manufacturers claim their nasal sprays are completely safe and can be used long term. They contain ingredients such as turmeric oil[1][2], tea tree oil[3][4][5][6] and capsaicin[7][8]which have been clinically proven to have anti-allergenic,anti-bacterial,anti-fungal,anti-histamine,anti-inflammatory,analgesic,anti-septic,anti-viral,decongestant and expectorant properties. A double blind cross overy study that was carried out by the Institute for Asthma and Allergy showed some evidence of their effciacy although more trials would be helpful.

was removed for a number of reasons.

First it is not based upon reviews as per WP:MEDRS but rather primary research. Also many of the refs do not pertain to the topic at hand and are WP:SYNTH. Please discuss before readding.Doc James (talk · contribs · email) 13:36, 1 May 2010 (UTC)

External Review[edit]

The following comments from external reviewer BSW-JMH are in conjunction with the joint Wikipedia talk:WikiProject Medicine/Google Project.

Hello Sinusitis writers and editors. The article has been give a Class B rating and high importance on the WikiProject Medicine quality scale. The article is, for the most part, complete, provide a substantial amount of information on sinusitis, and has appropriate references. As part of my review, I have revised the text to to enhance the clarity and flow of the article. Further, I have detailed some suggestions below that I hope are helpful to further enhance the scope of the article. I listed my comments by section to facilitate future revisions.

Introductory section[edit]

In general, this article references primary peer-review scientific literature. I think this is appropriate for citing specific pieces of information but can be problematic for disseminating general information to Wikipedia users. For example, the reference in the introductory section is an article in the American Journal of Medicine"", which may not be available to the general public. There are several public websites on sinusitis that would be useful to cite here. These include Google Health (https://health.google.com/health/ref/Sinusitis), Mayo Clinic (http://www.mayoclinic.com/health/chronic-sinusitis/DS00232/DSECTION%3Dsymptoms), Medline Plus (http://www.nlm.nih.gov/medlineplus/ency/article/000647.htm), and WebMD (http://www.webmd.com/allergies/sinus-infection).

Non of these references of really ideal. We should reference the peer reviewed literature as peer WP:MEDRS.Doc James (talk · contribs · email) 18:46, 20 May 2010 (UTC)

Classification[edit]

In general this was well written, a few minor changes were made. I revised the text to improve flow and clarity and rearranged the Chronic sinusitis section to make the sequence of information more logical. Citation needed tags were added to sentences that require references. Suggestions: The "By Location" subsection is very anatomical. The technical terms should be replaced with common language. Also a figure of the sinuses, such as this one (https://health.google.com/health/ref/graphic/19315) or found at this site (http://www.medicinenet.com/sinusitis/article.htm), would be a useful addition.BSW-JMH (talk) 16:41, 20 May 2010 (UTC)

Many thanks for the comments. The images has a copyright of ADAMs on it. Is it in the public domain? I have seen lots of images like this and have always been unsure thus have not used them.Doc James (talk · contribs · email) 17:05, 20 May 2010 (UTC)

Signs and symptoms[edit]

Again, minor changes were made and citation need tags were added. There is still a little technical language, such as ennervate, however I do not think it detracts from the article. But more common language is better, even in these cases. Suggestions: A reference or citation about the migrane drug would be helpful, including the manufacturer.BSW-JMH (talk) 17:23, 20 May 2010 (UTC)

Causes[edit]

Minor changes were made. Much of this section is redundant. The material should be expanded and possibly grouped with pathophysiology, as mentioned below.BSW-JMH (talk) 19:34, 20 May 2010 (UTC)

Pathophysiology[edit]

I rearranged the sentences. The lead sentence should refer to sinusitis and the supporting sentence further discuss biofilms. Suggestions: This section is extremely limited in scope and should be expanded. Key questions: What causes the inflammation in non-biofilm sinusitis? Is it the immune system, a histamine response, other cytokines and chemokines? Why does sinus inflammation often cause headaches and toothaches?BSW-JMH (talk) 17:29, 20 May 2010 (UTC)

Diagnosis[edit]

Minor changes were made. The last sentence is a little out of place. Addition of information about the other techniques used for diagnosis (CT scan, biopsy, cultures) would be a good addition to this section. This website has a nice slideshow of pictures related to sinus infections, polyps, and a color MRI of inflammed sinuses (http://www.medicinenet.com/sinusitis_pictures_slideshow/article.htm#)BSW-JMH (talk) 19:51, 20 May 2010 (UTC)

But of course all those images are copyrighted and unusable here. For images to be used they need to be in the creative commons.Doc James (talk · contribs · email) 19:54, 20 May 2010 (UTC)

Treatment[edit]

Only minor changes were made. This section is well written and referenced appropriately. Suggestions: Surgery- This section is more complicated than the other sections and written more for a physican. The language here should be made more colloquial, so that it can be understood by the general public.

The sentence on the use of antifungal treatments should be expanded as new information becomes available. Even including informed speculation from experts in fungal allergies would be a nice addition to make this into a paragraph.

References[edit]

  1. 6 needs to be updated (^ http://www.austinent.com/info/wiki/sinusitis.php)
  2. 18 needs more details (^ Harrison's Manual of Medicine 16/e)
  3. 30 needs more details (Bailey and Love)
  4. 50 first link goes to an archaeology paper — Preceding unsigned comment added by 128.240.229.3 (talk) 11:51, 26 April 2012 (UTC)

External Links[edit]

These are appropriate, though more should be added if possible.

I hope these suggestions are useful to the writers and editors of this article.BSW-JMH (talk) 20:32, 20 May 2010 (UTC)

I would like to add a useful blog site on sinusitis: http://sinusitisunderstood.blogspot.com/ I tried to add it but it was deleted. Can you explain to me why it was deleted. Thanks — Preceding unsigned comment added by Dribrook (talkcontribs) 12:38, 8 February 2011 (UTC)

Treatments and Prevention[edit]

I think its very important to reinstate the mention and expansion of the treatment section. Most people will not know what nasal irrigation is, and if they are looking for a self-treatment, they might need a little more information before they search further for nasal irrigation methods. I mentioned once, and will enclose again, an example of nasal irrigation, called the Neti Pot, as well as brief description of what its purpose is, and how it can help treat sinusitis. Alanna91 (talk) 20:09, 2 December 2010 (UTC)


I am also thinking about adding a Prevention section to this article, because I have found from personal experience, and from doctor's that there are ways in which you can protect yourself against sinus infections. Alanna91 (talk) 20:09, 2 December 2010 (UTC)

Yes good ideas. Please use reliable sources per WP:MEDRS. Doc James (talk · contribs · email) 21:02, 2 December 2010 (UTC)

Honey[edit]

I would like to have a discussion on why my edits made just a few weeks ago for honey were reverted. I had some private emails with James to which he gave brief one-sentence, inadequate, and disinterested response to my thoughtful writing (length). He's since locked the sinusitis article citing 'vandalism/spam' when there is hardly evidence to support as much, at least from the edits I was making or anyone else. Nothing warranted locking the article or ignoring genuine editors like myself as James did by saying 'obey the guide' but having no interest or meaning behind making that statement when I tried multiple times to interpret and follow the guide.

I asked to open the edit again with a new source http://www.metroatlantaotolaryngology.org/journal/nov10/biofilms%20and%20honey.pdf and he did not reply or unlock the article nor did he appear to consider modifying my original edit to make it follow the MEDRS guide. He also said my original citation of 'webmd' is not acceptable when the guide he pointed me to contradicts what he said and said WebMD is acceptable.

I would like an WP admin or editor from the medical community, besides 'Doc' James, to intervene here and help decide. — Preceding unsigned comment added by 76.175.156.55 (talk) 12:28, 12 March 2012 (UTC)

Hello, and thanks for your contributions so far. While I have no doubt that your edits were made in good faith, the content you added does appear to run afoul of WP:MEDRS, particularly this advice. Results from the in vitro study you cited, interesting as they are, are not yet significant enough to sway scientific consensus. The WEBMD article cites only the same study and therefore suffers a similar problem. For medical articles on Wikipedia, secondary sources are generally preferred. Wafflephile (talk) 21:15, 12 March 2012 (UTC)

I have checked the article history. There was a spate of vandalism on 10th February. There was another single episode of vandalism on 15th February. On 25th February, User:76.175.255.203 added good faith edits regarding the use of honey. In his reversion, Doc James acknowledged the good faith of the anonymous editor. Immediately after this, Doc James semi-protected the article, citing "persistent vandalism".

The rough guide to semi-protection states "Articles subject to heavy and continued vandalism can be semi-protected. There are no explicit rules that determine the level of vandalism that is necessary to trigger semi-protection. Administrators should use their best judgment to determine if semi-protection is warranted."

There was no vandalism between 15th February and 25th February. I would like to assume that the reversion of the anonymous IP's good faith contribution played no part in Doc James' decision to semi-protect the article. However, given the absence of vandalism, it is hard for me to believe that 76.175.255.203's edits were not a contributory factor.

With regard to duration, the guide states "If semi-protection is to be tried, its first application should be for a short duration, a few days or a week. If vandalism continues after the protection expires it can be added for a longer duration. At some point an administrator might determine that the semi-protection should be made indefinite."

This article has not previously been protected. Therefore the semi-protection should have been for a short duration, not indefinite. Indeed if semi-protection had been applied on the date of the vandalism (15th February) with the recommended duration, it would have expired by the time that Doc James actually applied semi-protection.

In my opinion, Doc James made two errors: one in applying semi-protection on 25th February, and another in applying indefinite duration. However I also believe that Doc James acted in good faith, intending to prevent harm to the article.

Disclosure: I am not an administrator. I have no authority to apply or remove semi-protection. Axl ¤ [Talk] 23:48, 12 March 2012 (UTC)

Regarding the reference "Effectiveness of honey on Staphylococcus aureus and Pseudomonas aeruginosa biofilms", it is a primary source, and only indirectly relevant to Wikipedia's article on "Sinusitis". I do not believe that it should be used here. Axl ¤ [Talk] 00:02, 13 March 2012 (UTC)
After a literature search, it appears that the use of honey is still at a relatively early stage of testing. Secondary sources do not support it. It does not have a place in Wikipedia's article (yet). Axl ¤ [Talk] 00:11, 13 March 2012 (UTC)
There has been a long history of inappropriate edits / vandalism to this article going back many month. I will give it another chance if we have more people watching it.--Doc James (talk · contribs · email) 06:17, 13 March 2012 (UTC)

-- I would like to thank Wafflephil above for helping with this important question. I realized after posting it without the original citation (WebMD is acceptable, then I gave a DIRECT citation by an American medical instituion), however you can find more research on bacterial Pseudomonas from skin infections like MRSA to anything dealing with bacteria and you'll find secondary sources. Also the primary source I provided is directly supporting CRS' (chronic sinusitis) total remission with a 100% effectiveness/safety profile limited to harmless short-lasting (one to several minutes) eye-watering allergic reactions when honey interacts with sinus tissues. Outside of that there are no known risks ONLY benefits. However there are many known risks with every possible antibiotic for CRS and all are only partially successful whereas in this study (ex vivo) honey was 100% effective. The strains used were also noted. If you dig deeper on Manuka honey you'll find copious institutional primary and secondary positions supporting honey's effectiveness at combating dermal and internal infections with complete safety and full effectiveness. This trend spans many cultures and societies (ancient and modern), and why it is a secret that the modern American medical community wants to keep silent about is beyond me. Many in the medical community don't even know the symbolism of their own profession's logo of Aesculapius chalice-crowned staph with snakes twisting to the substance -- the source is honey. [1]

Also think about this.. how many times is there a pathology that a pharmaceutical company patents a substance for treating, they get to mention themselves on article no matter how early or priliminary or isolated their 'scientific' (or 'clinical') study was, then they create original articles, etc .. even if there drug is half as effective as honey against a given disease. They get to mention their substance even if it might kill you, even if it might harm your organs or well-being in 'iatrogenic' hope that they're taking a more rigorous course not in vain but hoping to 'cure.' Well the problem is like with MRSA -- honey is entirely effective, cheap, safe, accessible, etc and you think its worth not mentioning Axl? Are you kidding me? Lets go back to my original body of honey text on sinusitis and make it accurate not censor it and associate it with vandalism. That just seems like you work for drug companies or are getting kickbacks, not interested in truth.

Follow the example of Jonas Salk (who cared less for profit) not Pfizer (who cared less than to profit).

Best to all. - Peter Herz - original sinusitis+honey editor — Preceding unsigned comment added by 76.175.156.55 (talk) 17:12, 13 March 2012 (UTC)

"Well the problem is like with MRSA -- honey is entirely effective, cheap, safe, accessible, etc and you think its worth not mentioning Axl?"

It's not my opinion. It is the opinion of secondary sources. Axl ¤ [Talk] 19:25, 13 March 2012 (UTC)

"That just seems like you work for drug companies or are getting kickbacks, not interested in truth."

I do not appreciate your baseless aspersion regarding my motives. If you are interested in constructive discussion, please refrain from ad hominem attacks. Axl ¤ [Talk] 19:25, 13 March 2012 (UTC)

ad hominem? I said you seem I was not sayng you must or likely do. There is ambiguity in my assertion just as you are lazily arguing there is a lack of supporting secondary sources. See Dog's original comment and you'll see there are plenty of secondary sources and related research. Its a safe substance. Period :) Appealed to emoticon! Oh NO! — Preceding unsigned comment added by 76.175.156.55 (talk) 23:52, 13 March 2012 (UTC)

--

Also let me further break it down for you Axl as you seemed to fail to analyze the above discussion or meaning behind it. The primary source is http://www.metroatlantaotolaryngology.org/journal/nov10/biofilms%20and%20honey.pdf which could have been used. The secondary source was WebMD's article edited by Kelley Colihan of WebMD Health News and Reviewed by Louise Chang, MD The only thing needed is to reedit my original honey text to reflect the information contained in these primary and secondary sources and that covers or should Wikipedia's No Opriginal Research rules just fine. Thanks for everyone's help. - Peter — Preceding unsigned comment added by 76.175.156.55 (talk) 01:01, 14 March 2012 (UTC)

Perhaps if/when there are randomised controlled trials to support the use of honey in sinusitis this topic can be revisited. However, as it currently stands, there is absolutely no evidence that honey is useful in a clinical sense in sinusitis. Watermelon mang (talk) 06:18, 14 March 2012 (UTC)
Hello Peter, the guideline at WP:MEDREV addresses this exact scenario. The WEBMD article is a simple news report and does not constitute a secondary source in the context of this discussion. I would love to engage on this topic again when more evidence and scientific analysis becomes available. Have a happy Pi Day! Wafflephile (talk) 17:16, 14 March 2012 (UTC)
Related discussion at User_talk:76.175.156.55#Edits. LeadSongDog come howl! 18:20, 14 March 2012 (UTC)


Watermelon.. doesn't apply to sinusitis? Did you even read the original research paper from Metro Atlanta Otolaryngology? Here's a clip from the thesis which in conclusion of this research paper proves honey is 100% effective against sinusitis ex vivo "Biofilms formed by Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) have been shown to be an important factor in the pathophysiology of chronic rhinosinusitis (CRS). As well, honey has been used as an effective topical antimicrobial agent for years. Our objective is to determine the in vitro effect of honey against biofilms produced by PA and SA."

Watermelon in case you were unaware "rhinosinusitis" means what you claimed isn't covered by this paper. Chronic just means it won't leave or keeps relapsing after apparently getting 'well' or maybe never totally well rather remission/dormant. And its no stretch of imagination to predict by copious anecdotal human testimony via Google and various health sites, and research conducted at University of Ottawa in 2010 with 80-100% success rates -- this proves that honey is safe and absolutely (100%) noteworthy, if not a cure in of itself. Watermelon: No 'randomized' trials required when the substance you're testing is 100% effective as it was in the Atalanta research article above. Here's a bit from the document since you seem to have no clue what you're referencing or discoursing about. And Wafflephil WebMD in this 'exact' situation is acceptable as a secondary source per Wikipedia's words on MEDREV. Why don't YOU go read it and search for WebMD before trying to teach me anything. Also if you look up the Wikipedia page on secondary sources for any kind of research (medical or none) you'll find there is a subjective definition and application of either 'primary' or 'secondary' term though generally its a primary source that is more allowable to include as a secondary source. Its only a concern when you have two secondary sources trying to conflate information/propaganda as a primary source. This is absolutely not the case with either WebMD nor Atalanta medical institution cited above. So why are people i.e. these admins/editors: AxlDoc James, Watermelon, LeadSongDog (constructive at least)) being hostile and deleterious about this study and information. Does it really hurt to note that honey might save or help you or a loved one with this condition better than any previously studied non-clinial treatment? Lets help people not hinder their access to this information claiming its not relevant or about sinusitis when it PRECISELY is, its not 'randomized' when it is 100% effective (duh), its doesn't include primary and secondary sources per WP:MEDREV which it DOES mention WebMD as being FINE with. Also a secondary editor/writer (Kelley Collihan) wrote the article on WebMD citing the Atlanta research paper, as well this same article was reviewed and signed by Louise Chang, MD. The MEDREV sections says "Peer reviewed medical information resources such as WebMD, UpToDate, Mayo Clinic, and eMedicine are usually acceptable sources in themselves, and can be useful guides about the relevant medical literature and how much weight to give different sources; however, as much as possible Wikipedia articles should cite the more established literature directly. That means multiple medically qualified people have weighed in on honey and said YES IT WORKS GREAT and is SAFE. Though I admit safe is not proclaimed by these docs just that it works great. Safety is just common sense, if you got honey up your nose or sinuses and it was dangerous, it would be common knowledge / sense. But again, a study was conducted in 2010 in Canada proving there are no safety concerns worth noting dealing with honey in sinus cavities.

So this resistance to publish is ridiculous. I'll be making an edit to my original honey edit and repost it so its at least more accurate including the fact that there's been no clinical studies on the safety of honey in the sinus cavities yet but there is some evidence that it is entirely capable of destroying the infection but leaving the patient's tissue unchanged and recovering from previous toxic species (bacterial/fungal) prolonged presence. And maybe worth noting that there are plenty of anecdotal reports that a honey-based saline rinse in the sinus will only be positive and therapeutic, not with notable side-effects except healing. -- Peter Herz

I'm certainly not being hostile. Just pointing out that the paper you cited is a primary study and is not a clinical trial directly looking at patients with sinusitis, rather it looks at bacterial biofilms in vitro and is therefore not directly relevant to an article discussing the treatment of sinusitis. Also you keep talking about "common sense" in safety of honey and anecdotal evidence. This is no longer acceptable in this era of evidence based medicine. After all, for centuries blood letting was used as a treatment for everything because it was "common sense" and there was plenty of anecdotal evidence, not that I'm suggesting honey is in the same category. For any treatment, randomised controlled trials (RCTs) are necessary to prove efficacy. Watermelon mang (talk) 02:39, 16 March 2012 (UTC)

Without even entering the argument of whether honey is relevant, I cannot allow a statement on common sesne that compares honey to blood letting go unchallenged. Honey is a known antibacterial and antiseptic. It was used historically and is still an "old wives cure" for many things (some of which have scientific backing). Please avoid hyperbolic leaps to ideas that are outdated for good reason. 83.70.170.48 (talk) 10:28, 19 June 2012 (UTC)


Table versus prose[edit]

Summary of sinusitis treatments[9][10]
Treatment Indication Rationale
Waiting for infection to pass Normal sinusitis Sinusitis is usually caused by a virus and the infection would not be affected by antibiotics or pharmaceutical treatment[9]
Antibiotics Abnormal sinusitis infection accompanied by other indicators Sinusitis usually not caused by bacteria, but accompanied by fever, extreme pain, or a skin infection, it may be.[9] Antibiotics only affect bacteria.
Nasal irrigation nasal congestion can provide relief by decongesting[9]
drink liquids thick phlegm remaining hydrated loosens mucus[9]
antihistamines concern with allergies antihistamines do not relieve typical sinusitis or cold symptoms much; this treatment is not preferable in most cases[9]
Nasal spray desire for temporary relief Relieves symptoms without treating cause; not recommended for more than three days' use[9]

If we have the content in both a table and in prose it sort of results in duplication. While the table looks nice I think we need to simple work on one good prose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:27, 23 February 2013 (UTC)

I support use of both table and prose here. I see the table has already gone... I thought it looks nice. Lesion (talk) 17:08, 15 July 2013 (UTC)
Actually I really like this table, I will use it as a template for all tables I put in. Adds a bit of color, no? Lesion (talk) 17:09, 15 July 2013 (UTC)
  1. ^ A.M.Siddiqui,X.Cui,R.Wu,W.Dong,M.Zhou.M.Hu,H.H.Suns,P.Wang. "The anti-inflammatory effect of curcumin in an experimental model of sepsis is mediated by up-regulation of perixosome,proliferator-activatedreceptor-gamma. Crit Care Med. 2006 Jul;34(7);1874-82.
  2. ^ HIH-listed human clinical trials on turmeric and curcumin February 2010.
  3. ^ Journal of Hospital Infections (2004;56:283-286), cited in Beauchamp,Kimberley.2004 "Tea Tree oil and Staph". BastyrCentre for Natural Health.
  4. ^ A.Shemesh and W.L.Mayo.1991 "Australian tea tree oil;a natural antiseptic and fungicide agent". Aust J.Pharm.72:802-803
  5. ^ C.D.Bishop (1995)."Anti-viral activity of the Essential Oil of Melalucia Alternifolia". Journal of Essential Oil Research:641-644
  6. ^ K.J.Josh,A.L.Pearce,G.Marshman,J.J.June Finlay, P.H.Hart "Tea Tree Oil ReducesHistamine Induced Skin Inflammation". British Journal of Dermatology, 2002, vol.147,no6, pp.1212-1217.
  7. ^ J.B.Epstein et.al.Topical application of capsaicin for treatment of oral neuropathic pain and trigerminal neuralgia. Oral Surg Oral Med Oral Pathos.1994 Feb;77(2):135-40
  8. ^ W.R.Robbins et.al.."Treatment of intractable pain with topical large-dose capsaicin:Preliminary report". Anesthetic & Analgesia, 86:57983, march 1998.
  9. ^ a b c d e f g Consumer Reports; American Academy of Family Physicians (April 2012). "Treating sinusitis: Don't rush to antibiotics" (PDF). Choosing wisely: an initiative of the ABIM Foundation. Consumer Reports. Retrieved August 17, 2012. 
  10. ^ American Academy of Allergy, Asthma, and Immunology. "Five things physicians and patients should question" (PDF). Choosing Wisely: an initiative of the ABIM Foundation. American Academy of Allergy, Asthma, and Immunology. Retrieved August 14, 2012. 

Acute versus chronic[edit]

As these disease are sufficient different they should probably be dealt with on separate pages. Similar to acute and chronic bronchitis.Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:47, 24 February 2013 (UTC)

Chronic sinusitis[edit]

This term should be explained somewhere. It's not defined anywhere, not introduced in classification, but used later in the body. This is confusing. --Piotr Konieczny aka Prokonsul Piotrus| reply here 02:57, 25 May 2014 (UTC)

"Chronic rhinosinusitis — when the signs and symptoms last for more than 12 weeks" is there. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:39, 25 May 2014 (UTC)

Proposed merge with Fungal sinusitis[edit]

Oppose merge. There is a proposal for merging fungal sinusitis into this page. While the fungal sinusitis article is practically incomprehensible at the moment, the topic deserves fuller coverage. I would like to see it remain a separate article because fungal sinusitis is generally much more serious, affects a different population (immunocompromised patients), and has different treatments, compared to bacterial and viral sinusitides.

I will work on the fungal sinusitis article at least to make it look a bit better. Gccwang (talk) 06:26, 26 August 2014 (UTC)

It was a copy and paste thus I deleted it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:35, 26 August 2014 (UTC)
Fungal rhinosinusitis should be discussed in the context of chronic rhinosinusitis, along with the other etiologic factors which are thought to be involved. 188.30.205.97 (talk) 06:00, 27 August 2014 (UTC)