The prevailing theories are: 1: Biofilm. Biofilm is where there's a lining of the sinuses has been so infiltrated with a bacterial load that there's a chronic reaction to that. Another theory there is that asthma, which is a chronic inflammation of the lower airway and sinusitis, chronic inflammation of the upper airway, are related. In that there are substances in the environment that we breathe in that in some people, their immune system reacts to it in such a way that they have this inflammatory cascade. Other people breathe in the same things from the environment, but their immune system doesn't have the same reaction to it.
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