... The NetiPotisasoothingnasallavage.Asaltmixtureofappropriateconcentration and temperatureisprepared. The patientleansover the sink and applies the NetiPotto the uppernostril, the salinesolutionflowsthrough the nasal and sinuscavities and around the backwallof the septum and washes the oppositenasal and sinuscavitiesbeforeexiting the dependentnostril. ... ctivatedagainst the fungus,while the immunesystemsofnormalhealthypeopledonot.Innormalhealthypeople, the fungus and fungalsporesthatarebreathedinto the noseappeartodonoharm.Inchronicsinusitispatients, the immunereactionagainst the funguscausesimmunecellstoreleasesubstancesthatkill the fungus.Itisbelievedby the researchersat the MayoClinicthatthesesubstancesalsodamage the nasal and sinuslinings and causethemtobecomeinflamed and irritated.(50) The immune system ofchronicsinusitispatientsisactivatedagainst the fungusbutendsuphurting the patient. ... terlevelrises and areservoirforms.Similarly,if the osteomeatalcomplexisblocked,abackupofmucusoccurs.Thiscanleadtoaconditionthatleadstoinfection.Bacterialivein the nose and sinuses;however,inaninfectiousstatesomesubset(s)ofbacteriahavereproducedoutofproportiontoothers.Thisbacterialovergrowthisoftenpresentinsinusitis–particularlyacutesinusitis.Anyprocessthatcausesmucosalinflammationinto the sensitiveareaof the osteomeatalcomplex(OMC)canocclude the othersinusesthatdrainintothiscrossroadzone.(16‐20)Blockageof the smallopeningsfromswelling(causedbyinfection,allergy, and othercauses)canalsoresultinsinusitis.Whenobstructionoccurs, the mucusisretainedin the sinuscavity.Thesestagnantsecretionsthicken and provideamedium for bacterialgrowth.Obstructionalsoimpairsaeration and gasexchangewithin the sinuscavity.Absorptionoftrappedoxygenleadstohypoxiaordecreasedoxygenlevelswithin the sinus,whichexacerbatessinusitis.Thesechangesleadtodamage and dysfunctionof the cilia and epithelium. The retainedsecretions and infectionleadtofurthertissueinflammation,whichinturnleadstofurtherblockage.Thesechanges120help the bodyfightsinusitis.(51‐52).However,onecriticismofthisuseof the macrolideantibioticsisthatthereisariskthatbacteriacouldbecomeresistanttotheseantibioticsiftheyareoverused,therebypotentiallycreatingadifficultproblemintreatinginfectionwithresistantbacteria.N.Steroids...