rhinosinusitt

Rhinosinusitt, also known as rhinosinusitis, is an inflammation of the mucosa of the nasal cavities and paranasal sinuses. It is commonly classified by duration: acute (<4 weeks), subacute (4–12 weeks), chronic (>12 weeks). A recurrent acute form may occur with several episodes per year.

Symptoms typically include nasal congestion, facial pain or pressure, purulent nasal discharge, reduced sense of smell, and sometimes fever. Acute rhinosinusitt often presents with fever and more pronounced symptoms, while chronic forms tend to have longer-lasting symptoms with less fever.

Viral upper respiratory infections are the most common cause. Bacterial infection may occur in acute bacterial rhinosinusitis. Chronic rhinosinusitt is associated with allergies, asthma, nasal polyps, immune dysfunction, smoking, and environmental irritants. Risk factors also include prior sinus disease and dental infections.

Diagnosis is usually clinical, but nasal endoscopy can reveal inflammation and purulent discharge. Computed tomography (CT) scanning is reserved for chronic or recurrent cases or when surgery is considered, to assess the extent of disease and aid planning.

Treatment focuses on symptom relief and reducing inflammation. Many cases resolve with nasal saline irrigation, humidification, and intranasal corticosteroids. Analgesics may be used for comfort. Antibiotics are reserved for cases meeting criteria for acute bacterial rhinosinusitt or persistent bacterial symptoms, with first-line options such as amoxicillin-clavulanate and alternatives for allergies or resistance. Chronic rhinosinusitt may require longer courses of intranasal steroids, ongoing saline irrigation, management of comorbidities, and, if symptoms persist, referral to an ear, nose, and throat specialist for consideration of functional endoscopic sinus surgery.

Complications are uncommon but can include orbital or intracranial spread. Most acute cases improve, while chronic rhinosinusitt can be persistent; prevention includes allergy control, avoidance of irritants, good nasal hygiene, and vaccination when appropriate.