Overview of Rhinosinusitis

Causes, Symptoms, Diagnosis, and Treatment

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Rhinosinusitis is a common disorder related to inflammation of your nasal passages and sinus cavities. About one out of every eight people experience rhino sinusitis every year, particularly if there are other risk factors such as smoking, asthma, dental problems, a weakened immune system, swimming, or rapid changes in air pressure (such as occurs with air travel or scuba diving). Most cases of rhinosinusitis are caused by allergies or infection.

Rhinosinusitis is divided into four categories depending on how long the illness lasts:

  • Acute rhinosinusitis: symptoms last less than 4 weeks
  • Subacute rhinosinusitis: symptoms last 4 to 12 weeks
  • Chronic rhinosinusitis: symptoms last longer than 12 weeks
  • Recurrent rhinosinusitis: 4 or more episodes per year

Acute sinusitis is most often the result of an upper respiratory tract infection. Chronic sinusitis is associated with allergies, nasal polyps, deviated septum, or even an undiagnosed fungal infection (most often in immune-compromised people).

Symptoms

Symptoms of rhinosinusitis are similar regardless of the duration or cause, and may include:

Unlike adults, children with rhinosinusitis will typically have a cough.

Because not all of the symptoms are experienced in the nose or sinuses, your dentist or optometrist may be the first person to spot them and refer you to an otolaryngologist (an ear, nose, and throat specialist).

If left untreated, chronic rhinosinusitis can lead to other more serious complications, including sleep apnea and nasal polyps.

Diagnosis

Your doctor will likely not perform any tests beyond their general assessment for rhinosinusitis. This can usually be diagnosed based on the history of your symptoms and physical exam findings.

If your doctor suspects an infection, a nasal or sputum culture and possibly a CT scan may be ordered to identify the cause and extent of the infection. This can help with the selection of the appropriate antibiotic.

If your doctor believes that your rhinosinusitis is related to allergies, you will likely be referred to an allergist for a thorough evaluation of your allergies. In order to achieve maximal relief, you will need to avoid allergens that are causing your symptoms.

Treatment

Treatment for rhinosinusitis varies and is usually based on the duration and severity of symptoms. If your doctor's evaluation suggests that the infection is bacterial, antibiotics will be prescribed. Antibiotics will not be given for infections caused by viruses since antibiotics will have no effect whatsoever on these infections.

Many of the symptoms related to rhinosinusitis can be managed using over-the-counter pain relievers (like acetaminophen or ibuprofen), decongestants (like pseudoephedrine), nasal irrigation, or topical steroids.

Allergic rhinosinusitis may be treated with antihistamines like Claritin, Zyrtec, or Allegra.

Nasal decongestants are commonly used to help reduce inflammation in your nasal passages. Since many decongestants are now available over-the-counter it is common to self-medicate with these drugs before seeing a physician.

It is important to avoid the overuse of nasal decongestants, such as Afrin (oxymetazoline) or Neo-Synephrine (phenylephrine hydrochloride), which can lead to rebound congestion and nasal spray addiction.

A Word From Verywell

Chronic sinusitis has been shown to be self-diagnosed incorrectly by people who mistakenly believe that they are suffering from seasonal allergies. Similarly, people with migraines have been known to incorrectly treat themselves for symptoms of sinusitis.

To this end, it is important to see a proper diagnosis from a qualified medical practitioner if your symptoms are severe, persistent, recurrent, worsening, or interfering with the quality of your life.

Home Remedies for Post-Nasal Drip
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Article Sources
  • Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis. UpToDate website. http://www.uptodate.com (Subscription Required). Updated November 8, 2016. Accessed July 7, 2017.
  • Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis. UpToDate website. http://www.uptodate.com (Subscription Required). Updated October 28, 2016. Accessed July 7, 2017.