[The sinusitis-bronchial syndrome from the internal medicine-pneumologic viewpoint--comment on therapeutic procedure]

Chronic sinusitis is a nonspecific inflammatory disease of the sinusoidal mucosa with a tendency to polypoid morphological changes. Therefore a long term antiinflammatory drug treatment is often necessary. Antihistaminic drugs, sodium cromoglycate, and decongestants (alpha-adrenergic agents) may be useful. However, topic and systemic corticosteroids are usually necessary in order to reduce swelling and infiltration of the nasal and sinusoidal mucosa, to reduce the tendency of nasal and sinusoidal growth of polyps, to reduce nasal airways obstruction, and thereby possibly recurrent sinusoidal infection. Antibiotics are only useful in acute sinusitis. Operative measures are widely used, but controlled studies are lacking. From the internistic standpoint they should only be considered if drug treatment is ineffective or in massive polyposis or recurrent acute sinusitis. Supportive drug therapy is necessary to prevent relapses.