Association of chronic sinusitis with stroke and dementia: inflammation and CSF dynamics

Background and Objectives: Chronic sinusitis (CS) is a common inflammatory disorder associated with an increased risk of stroke, coronary heart disease (CHD), and dementia, although many studies were cross-sectional design. Increased systemic inflammation has been suggested as mediating pathway, although local infectious spread through nasal lymphatic pathways connecting the nasal mucosa and cribriform plate to intracranial compartments may also contribute. This could impair cerebrospinal fluid (CSF) dynamics, potentially relevant to cerebral small vessel disease (cSVD), in which glymphatic failure has been implicated. We investigated associations of CS with vascular and cognitive outcomes, and explored potential inflammatory and CSF dynamics-related pathways.