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To the Editor: The Clinical Crossroads article¹ describing care of a patient with recurrent sinusitis presents a common clinical scenario. Unfortunately, this article also documents a common historical course of these patients: repeated medical management, followed by a surgical recommendation, all without a confirmed diagnosis.

Mr S reports 21 years of "recurrent sinusitis." The presentation describes monthly autumn and winter episodes, which are treated with multiple medications that do not work very quickly. However, we do not know the duration of these episodes or how soon he received antibiotics. Unfortunately, patients often receive antibiotics early in a viral illness and improve in 7 days, while others acquire a diagnosis of "recurrent sinusitis" without radiographic confirmation.

Furthermore, this medical history does not explore possible predisposing factors such as exposure to children who attend day care and who have frequent upper respiratory tract infections, smoking or tobacco smoke exposure, history of using . . . [Full Text of this Article]

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