What is the Role of Air Pollution in Chronic Rhinosinusitis?

Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory disorder, and several environmental factors may be contributing to disease pathophysiology, including air pollutants. Tobacco smoke and occupational exposures also have been associated with CRS, and environmental exposures may contribute to the variability seen in disease endotype. Animal models that investigate the potential of air pollutants to induce chronic inflammation provide further insight into plausible triggers and modifiers of disease, including contributions to barrier disruption, alterations in the microbiome, and immune dysfunction. Additional studies are needed to further elucidate the role of environmental exposures on CRS pathophysiology and patient outcomes.