Try this.

http://www.aafp.org/afp/20021115/1882.html

Also ask you ENT what the sensivity and selectivity of the cultures is
and what preportion of bacteria that can be cultured.
Dollars to donuts he does not have a clue.

The catch 22 is that the way the laws are written ONLY MDs are allow
to examine human tissue, unless it can be defined as waste water or a
waste stream.
I can not use stains and DNA or RNA probes identily the density of
different bacterial forms from location to location on anyone other
than myself.  because I would violate 16 different laws. So only MDs,
after approval of the institution's Human Studies Commitee can work
with identifable human tissue, and while the dentists are sequencing
the metagenome of the mouth, everything in sight, the ENTs are
oblivious.
The lining of the sinuses develops from tissue of the "primative
mouth" by the way.  If we defined the sinuses, ostemeatal complex, and
adenoids and tonsiles as part of the mouth and thus fair game for
dentists, they would have compared the metagenome of goos from CS
suffers with healthy controls and solved the thing three years ago.

About the MRIs, a couple of chemical engineers  developed a zinc based
stain to  that turns the biofilms pink. The ENTs are not terribly
interested.
A contrast agent was developed that highlights beta amyloid. (that
stuff in altzheimer's plaques)
It keeps lighting up the sinuses with far greater intensity than the
brain, so they wonder at it's usefullness!
?????
E-coli makes beta amyloid and e-coli killing phages cure altzheimers
in mice, so it does not take a genuis to make a connection between
amyloid signal showing up in the sinuses, amyloid producing bacteria
in inflammed sinuses and amyloid plaques in the brain.
And these people are no dummies.
One truely wonders if the medical research community is so busy
playing the grant game of seeing how little information that they can
produce for a certain amount of money and still get funding, that they
forget that they and their families and loved ones have sinuses and
brains too.

Susan:
Here is an artical that I have posted before.
http://www.aafp.org/afp/20041101/1685.html

selectivity and sensitivity with sinus aspiration as a reference
standard.
I have ask Judy and Steven for their references several times, and
they havn't come up with anything so far.

For plain radiography showing mucosal thicking they show 90%
sensitivity (which means 10% false negs) and 61% selectivity (which
means 39% false positives).

About false negative cultures.  Bacteria that are unculturable can
still cause havoc, but it they can't cultrue it, they can't find in
cultures. (Duh). Pseudomodas used to be unculturable.

It is not uncommon to find 3 or 7 species that only grow when are all
are found togther.  Because they don't grow in isolation the present
system is not set up to deal with them even if they produce important
toxins, so it pretends that they do not exist.
Do a search on "unculturable bacteria" and see the gap between what
the microbiologist finds is there and what the MD considers for
yourself.

I had not heard any such data myself.  But it makes sense, given the
complexity of those tiny honeycomb partitions in the ethmoids.

Get a second opinion.

In my experience, the best ENTs will diagnose based on the full range of
 data, ESPECIALLY a detailed patient history and symptomatology.  My
current ENT told me that in his *judgment*, based on my patient
*history*, he was sure I had chronic sinusitis even though the CT scan
didn't show it.  He turned out to be right, and during surgery he found
a mucocele in a left ethmoid that the CT scan had totally missed.  Get
it, "judgment," "history," "symptomatology" are at least as important as
the radiological scans.

You need to find one of *those* ENTs for a second opinion.

It might be worth purchasing this paper for reference:
http://tinyurl.com/36xbrr

Like I said, the results are not encouraging.

Well, I understand that problem.  The *only* physician I ever saw who
does nasal wash cultures routinely is Dr. Wellington Tichenor in New
York.  Even my own ENT doesn't do that.  He and other ENTs do the usual
type of culture where the pus is sampled at the sinus ostia.  And if
there's no visible pus to sample, then they can't do that type of culture.