Biofilms and Fungi
Chronic sinus inflammation frequently involves biofilms — organised bacterial communities that tolerate antibiotics far better than free-floating bacteria — and fungal colonisation. Both explain the familiar pattern: temporary improvement on treatment, return within weeks.
Standard swabs often miss both, so the culture comes back unremarkable and the next antibiotic is prescribed.
The Mould Connection
The sinuses are the first tissue to meet whatever is in the air you breathe all night. In water-damaged buildings, that includes mould spores and mycotoxins, and the sinuses can become a reservoir that keeps immune activation running long after the exposure ends.
This is why a sinus history matters in mould cases and why an environmental assessment belongs in a sinus workup when symptoms are chronic.
What a Workup Looks At
Beyond imaging and ENT assessment: fungal involvement, biofilm considerations, mycotoxin testing where exposure is plausible, histamine and mast cell activity, gut health and immune status, and food triggers driving mucus production.
Structural problems such as a deviated septum or polyps are a surgical question and belong with ENT — root-cause work sits alongside that, not instead of it.
