Recurrent sinusitis that responds to antibiotics only to return within weeks is the pattern that most clearly suggests an underlying allergic component, and in Bengaluru, where house dust mite, cockroach, and Parthenium sensitisation are highly prevalent, it is one of the most common presentations I see at Trustwell Hospitals. The mechanism is straightforward: allergic rhinitis produces persistent mucosal inflammation and oedema that blocks the sinus drainage passages, creating conditions in which bacteria thrive. Each antibiotic course treats the superimposed bacterial infection but leaves the underlying inflammatory environment completely unchanged, which is why the infection returns. Identification of the specific allergen driving nasal inflammation through skin prick testing and specific IgE measurement - and then addressing it through allergen avoidance strategies and appropriate pharmacotherapy - reduces the frequency and severity of sinusitis in most patients. For patients whose symptoms remain inadequately controlled despite optimal medical management, FESS improves sinus drainage surgically. But for many patients with allergy-driven recurrent sinusitis, treating the allergy eliminates the need for sinus surgery, which is the preferred outcome for everyone involved.
Written by Dr. Rajendran Dinesh Kumar, MBBS, MS ENT, AASC (Allergy Asthma Specialist Course), FAAP, Consultant ENT Specialist and Allergy, Asthma Specialist, Trustwell Hospitals Pvt. Ltd., JC Road, Vinobha Nagar, Sudhama Nagar, Bengaluru, Karnataka 560002. 16+ years, 20,000+ patients. Phone: 9620928650.
