Allergy and sinus disease

William B Smith and Peter-John Wormald
Med J Aust 2006; 185 (10): . || doi: 10.5694/j.1326-5377.2006.tb00694.x
Published online: 20 November 2006

Does allergy predispose to acute infectious sinusitis? Some patients report sinus infections during the hayfever season, and it is commonly supposed that congestion associated with allergic rhinitis can predispose to infectious sinusitis by interfering with the function of the sinus ostia. However, there is no good evidence to support this hypothesis, and no good evidence that specific treatment by allergen avoidance or immunotherapy (or even non-specific treatment with continuous topical corticosteroids) can prevent acute infectious sinusitis in people who do not have underlying chronic sinusitis. Most episodes of acute sinusitis are sequelae to viral upper respiratory tract infections. However, topical corticosteroids are an effective adjunct to antibiotic therapy in cases of acute infectious sinusitis, with or without coexisting allergy (Level II).1

  • 1 Clinical Immunology and Allergy, Royal Adelaide Hospital, Adelaide, SA.
  • 2 Flinders Medical Centre, Adelaide, SA.
  • 3 Department of Surgery — Otorhinolaryngology, Head and Neck Surgery, University of Adelaide and Flinders University, Adelaide, SA.


  • 1. Dolor RJ, Witsell DL, Hellkamp AS, et al. Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. The CAFFS Trial: a randomized controlled trial. JAMA 2001; 286: 3097-3105.
  • 2. Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. J Allergy Clin Immunol 2004; 114 (6 Suppl): 155-212.
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  • 4. Blaiss MS. Expanding the evidence base for the medical treatment of nasal polyposis. J Allergy Clin Immunol 2005; 116: 1272-1274.
  • 5. Hissaria P, Smith W, Wormald PJ, et al. Short course of systemic corticosteroids in sinonasal polyposis: a double-blind, randomized, placebo-controlled trial with evaluation of outcome measures. J Allergy Clin Immunol 2006; 118: 128-133.


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