What Is Rhinosinusitis and How Is It Treated?

Written by Medicover Team and Medically Reviewed by Dr Shashi Kiran Somala , ENT

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Rhinosinusitis is inflammation and swelling of the nasal passages and sinuses. The condition can block normal sinus drainage, causing mucus buildup, nasal congestion, facial pressure and difficulty breathing through the nose.

Rhinosinusitis may develop after a respiratory infection or occur due to allergies, structural problems or other conditions that interfere with normal sinus drainage. Symptoms may be short-term or persist for several months.

Persistent inflammation can affect sleep, concentration and daily activities. Identifying the underlying cause and receiving appropriate treatment can help relieve symptoms and reduce the risk of complications.

What Are the Types of Rhinosinusitis?

Rhinosinusitis can be classified by symptom duration and underlying cause of inflammation.

Acute Rhinosinusitis: Symptoms develop suddenly and usually last less than four weeks, often following a viral respiratory infection.
Subacute Rhinosinusitis: Symptoms persist for four to 12 weeks.
Chronic Rhinosinusitis: Inflammation and symptoms continue for more than 12 weeks despite treatment.
Recurrent Acute Rhinosinusitis: Several separate episodes of acute rhinosinusitis occur within a year, with symptom-free periods between episodes.
Allergic Fungal Rhinosinusitis: A form of chronic rhinosinusitis caused by an allergic reaction to fungi present in the sinuses.
Fungal Rhinosinusitis: A sinus condition caused by fungi that may be invasive or noninvasive.
Rhinosinusitis With Nasal Polyps: Chronic inflammation occurs along with benign growths called nasal polyps.

What Are the Symptoms of Rhinosinusitis?

Symptoms of rhinosinusitis vary depending on the cause and duration of the condition. They commonly affect the nose, sinuses and surrounding areas of the face.

Nasal Congestion: Swollen nasal tissues can cause a blocked or stuffy nose and difficulty breathing.
Facial Pain or Pressure: Pressure or discomfort may develop around the cheeks, forehead, eyes or nose.
Runny Nose: Mucus may drain from the nostrils and can vary in colour and thickness.
Postnasal Drip: Mucus may drain down the back of the throat and cause irritation.
Reduced or Lost Sense of Smell: Nasal inflammation and blockage can interfere with the ability to smell.
Cough: Postnasal drainage may trigger coughing, particularly at night.
Fatigue: Persistent symptoms and disturbed sleep may cause tiredness.
Headache: Sinus pressure and inflammation may contribute to headaches.
Bad Breath: Mucus buildup and infection may cause unpleasant breath.
Fever: A fever may occur, particularly with some acute infections.

What Causes Rhinosinusitis?

Rhinosinusitis develops when inflammation blocks the normal drainage pathways of the sinuses. Mucus can then accumulate, causing pressure and creating conditions that may support infection.

Viral Infections

Viral infections, such as the common cold, are a frequent cause of acute rhinosinusitis. Swelling from the infection can temporarily block sinus drainage.

Bacterial Infections

A bacterial infection may develop when blocked sinuses allow mucus and bacteria to accumulate. This is less common than viral rhinosinusitis.

Allergies

Allergic reactions can cause persistent inflammation and swelling of the nasal passages, interfering with normal sinus drainage.

Fungal Infections

Fungi can cause different forms of rhinosinusitis, ranging from allergic reactions to invasive infections, particularly in people with weakened immune systems.

Nasal Polyps

Nasal polyps can obstruct the nasal passages and sinus openings, increasing the risk of chronic inflammation and recurrent symptoms.

Deviated Septum

A deviated septum may narrow one or both nasal passages and interfere with sinus drainage.

When Should You See a Doctor for Rhinosinusitis?

Medical evaluation by an ENT Specialist is recommended when sinus symptoms are severe, repeatedly return, persist longer than expected, or worsen after initial improvement. Prompt assessment can identify infections, structural problems, or complications that may require specific treatment.

You should see a doctor if you have:

Symptoms that persist, worsen or frequently return
Severe facial pain, pressure or persistent nasal congestion
Reduced sense of smell or thick nasal discharge that does not improve

Get medical help immediately if:

Swelling or redness develops around the eyes
Vision changes, severe headache or neck stiffness occurs
Confusion, severe weakness or difficulty breathing develops

These could be signs of a serious complication like a spreading infection, which needs urgent care.

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How Is Rhinosinusitis Diagnosed?

Rhinosinusitis is usually diagnosed by reviewing symptoms and examining the nose and face. Additional tests may be recommended for persistent, recurrent, severe or unusual cases.

Medical History

The doctor may ask about the duration and pattern of symptoms, previous sinus problems, allergies, respiratory infections and treatments already used.

Physical Examination

The healthcare provider may examine the nasal passages and check the face for tenderness, swelling and other signs of sinus inflammation.

Nasal Endoscopy

A thin, flexible instrument with a camera may be used to examine the nasal passages and sinus openings for swelling, mucus, polyps or structural abnormalities.

Imaging Studies

A CT scan may be used to assess the sinuses in chronic, recurrent or complicated cases. MRI may be recommended when specific complications or abnormal tissue are suspected.

Allergy Testing

Skin or blood tests may help identify allergens when allergic inflammation is suspected as a cause of recurring symptoms.

Nasal or Sinus Samples

Samples of nasal or sinus secretions may be collected in persistent or severe cases to identify bacteria, fungi or other causes of infection.

How Is Rhinosinusitis Treated?

Treatment for rhinosinusitis depends on the cause, severity and duration of symptoms. The goals are to reduce inflammation, improve sinus drainage, relieve symptoms and treat infections when present.

Nasal Irrigation

Rinsing the nasal passages with a saline solution can help remove mucus, allergens and irritants while keeping the nasal lining moist.

Nasal Corticosteroid Sprays

These sprays reduce inflammation in the nasal passages and may improve congestion, drainage and other symptoms, particularly in chronic or allergic rhinosinusitis.

Pain Relief

Appropriate pain-relieving medicines may help reduce headaches, facial discomfort and fever when used as directed.

Antibiotics

Antibiotics may be prescribed when a bacterial infection is suspected or confirmed. They are not effective against viral infections.

Decongestants

Decongestants may provide short-term relief from nasal blockage. Nasal decongestant sprays should not be used longer than recommended because prolonged use can cause rebound congestion.

Allergy Treatment

When allergies contribute to rhinosinusitis, treatment may include avoiding known triggers, allergy medicines or immunotherapy.

Surgery

Surgery may be considered for chronic or recurrent rhinosinusitis that does not improve with medical treatment. Procedures can improve sinus drainage and address nasal polyps or structural blockages.

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What Are the Risk Factors for Rhinosinusitis?

Certain conditions and environmental exposures can increase the risk of developing acute, recurrent or chronic rhinosinusitis.

Allergies: Persistent allergic inflammation can block normal sinus drainage.
Nasal Polyps: These growths may obstruct sinus openings and contribute to chronic symptoms.
Deviated Nasal Septum: Structural narrowing can interfere with airflow and drainage.
Respiratory Tract Infections: Viral infections can cause swelling that blocks the sinuses.
Cystic Fibrosis: Thick mucus can impair normal sinus drainage.
Immune System Disorders: Reduced immune function can increase susceptibility to persistent or unusual infections.
Exposure to Pollutants or Irritants: Smoke, chemicals and air pollution can inflame the nasal passages.
Smoking: Tobacco smoke can damage the respiratory lining and interfere with mucus clearance.
Dental Infections: Infections involving the upper teeth can occasionally spread to nearby sinuses.
Gastroesophageal Reflux Disease: Reflux may contribute to upper airway irritation in some people.

What Are the Complications of Rhinosinusitis?

Most cases improve without serious complications. However, untreated or severe infections can occasionally spread beyond the sinuses.

Chronic Rhinosinusitis: Persistent inflammation may continue for more than 12 weeks.
Orbital Infection: Infection can spread to tissues around the eye and cause swelling, pain or vision problems.
Bone Infection: Rarely, infection may spread to nearby facial bones.
Intracranial Infection: In rare cases, infection can spread to tissues surrounding the brain.
Loss of Smell: Persistent inflammation may reduce or impair the sense of smell.
Worsening Asthma: Chronic upper airway inflammation may aggravate asthma symptoms.

How Can Rhinosinusitis Be Prevented?

Not every case of rhinosinusitis can be prevented, but reducing respiratory infections, controlling allergies and avoiding nasal irritants may lower the risk.

Wash your hands regularly to reduce exposure to respiratory infections.
Avoid close contact with people who have colds or other respiratory illnesses.
Manage allergies according to medical advice.
Avoid smoking and exposure to secondhand smoke.
Reduce exposure to air pollution and other respiratory irritants.
Use a humidifier when indoor air is very dry and keep the device clean.
Use saline nasal rinses correctly when recommended.
Seek treatment for persistent dental or nasal problems.

What Is the Outlook for Rhinosinusitis?

Most cases of acute rhinosinusitis improve with supportive care and appropriate treatment. Chronic or recurrent rhinosinusitis may require longer-term management to control inflammation and address underlying allergies or structural problems.

Regular medical follow-up can help people with persistent symptoms identify triggers, adjust treatment and reduce the risk of complications or repeated episodes.

Frequently Asked Questions

1. What is rhinosinusitis?

Rhinosinusitis, commonly known as sinusitis, is the inflammation of the lining of the sinuses and nasal passages.

2. What are the common symptoms of rhinosinusitis?

Common symptoms of rhinosinusitis include facial pain or pressure, nasal congestion, postnasal drip, and reduced sense of smell.

3. What are the main causes of rhinosinusitis?

Rhinosinusitis can be caused by viral infections, bacterial infections, allergies, nasal polyps, or a deviated nasal septum.

4. How is rhinosinusitis diagnosed?

Rhinosinusitis is diagnosed based on symptoms, physical examination, and sometimes imaging studies like CT scans or nasal endoscopy.

5. What are the treatment options for rhinosinusitis?

Treatment options for rhinosinusitis may include antibiotics (if bacterial), decongestants, nasal corticosteroids, saline nasal irrigation, and in severe cases, surgery may be recommended.