The role of fungus in CRS remains to be fully elucidated. The hypothesis has been put forth that an inappropriate host response to fungal organisms may be the underlying pathogenic factor in CRS and nasal polyposis. It is clear that fungal hyphae are present in nasal mucin in both patients with CRS and healthy controls; however, the significance of this finding remains controversial. Future studies will need to identify why certain individuals mount a vigorous immunologic response to ubiquitous environmental fungi, with resulting sinonasal inflammation and the development of CRS, while others do not. Finally, there is hope that better treatments will be developed as our understanding of the pathophysiology of CRS improves.
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