Updates to the Current Understanding of the Relationship Between Allergy and Chronic Sinusitis

To examine the relationship of chronic rhinosinusitis (CRS) and atopic disease. CRS with nasal polyps (CRSwNP) has been shown to be associated with high aeroallergen sensitivity and local allergic response, but with no difference in imaging, symptomatic severity, or disease recurrence rates in atopic vs. non-atopic individuals. There is conflicting evidence for CRS without nasal polyps (CRSsNP) with regard to the relationship with atopic disease. There may, however, be differential molecular profiles between atopic and non-atopic patients with CRSsNP. There is no consensus as to whether atopic disease is related to CRS. Recent studies have shown that atopic disease may be implicated in pathogenesis, but may not contribute to clinical severity. It should, however, be noted CRS likely has multifactorial etiologies. Finally, specific subtypes of CRS, such as central compartment atopic disease (CCAD), are likely atopy driven and allergic management should play a key role in treatment of these patients.