Rhinosinusitis (patient information)

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What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?


Treatment options

Where to find medical care for Rhinoinusitis?

What to expect (Outlook/Prognosis)?

Possible complications


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Dima Nimri, M.D. [2]


Rhinosinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.

What are the symptoms of Sinusitis?

The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms. Symptoms include:

Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 8 weeks.

Symptoms of Rhinosinusitis in children include:

  • Cold or respiratory illness that has been improving and then begins to get worse
  • High fever, along with a darkened nasal discharge, for at least 3 days
  • Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving

What causes Rhinosinusitis?

The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.

When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Rhinosinusitis can occur from one of these conditions:

Rhinosinusitis can be:

  • Acute -- symptoms last 2 - 8 weeks
  • Chronic -- symptoms last much longer

Acute sinusitis is caused by damage to the lining of the sinuses from surgery or infections. Chronic sinusitis may be caused by bacteria or a fungus.

Who is at highest risk?

The following may increase your risk or your child's risk of developing Rhinoinusitis:

When to seek urgent medical care?

Call your doctor if:

A green or yellow discharge does not necessarily indicate a sinus infection or the need for antibiotics.


The doctor will examine you or your child for Rhinosinusitis by:

Regular x-rays of the sinuses are not very accurate for diagnosing Rhinosinusitis.

Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose Rhinosinusitis. This is usually done by doctor who specializes in ear, nose, and throat problems (ENT).

However, these tests are not very sensitive at detecting Rhinosinusitis, and are often considered unnecessary.

A CT scan of the sinuses may also be used to help diagnose Rhinosinusitis. If Rhinosinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.

If you or your child has chronic or recurrent Rhinosinusitis, other tests may include:

Treatment options

Try the following measures to help reduce congestion in your sinuses:

  • Apply a warm, moist washcloth to your face several times a day.
  • Drink plenty of fluids to thin the mucus.
  • Inhale steam 2 - 4 times per day (for example, sitting in the bathroom with the shower running).
  • Spray with nasal saline several times per day.
  • Use a humidifier.

Be careful with over-the-counter spray nasal decongestants. They may help at first, but using them beyond 3 - 5 days can actually worsen nasal congestion.

Also, for sinus pain or pressure:

  • Avoid flying when you are congested.
  • Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
  • Try acetaminophen or ibuprofen.

Antibiotics are usually not needed for acute sinusitis. Most of these infections go away on their own. Even when antibiotics do help, they may only slightly reduce the time you or your child is sick. Antibiotics may be prescribed sooner for:

At some point, your doctor will consider prescription medications, antibiotics, further testing, or referral to an ear, nose, and throat (ENT) or allergy specialist.

Other treatments for Rhinosinusitis include:

Acute sinusitis should be treated for 10 - 14 days. Chronic sinusitis should be treated for 3 - 4 weeks. Some people with chronic sinusitis may need special medicines to treat fungal infections.

Surgery to clean and drain the sinuses may also be necessary, especially in patients whose inflammation returns, despite medical treatment. An ENT specialist (also known as an otolaryngologist) can perform this surgery.

Most fungal sinus infections require surgery. Surgical repair of a deviated septum or nasal polyps may prevent the condition from returning.

Where to find medical care for Sinusitis?

Directions to Hospitals Treating Sinusitis

What to expect (Outlook/Prognosis)?

Sinus infections are usually curable with self-care measures and medical treatment. If you are having recurrent attacks, you should be checked for underlying causes such as nasal polyps or other problems, such as allergies.

Possible complications

Although very rare, complications may include:


The best way to prevent rhinosinusitis is to avoid or quickly treat flus and colds:

Other tips for preventing rhinosinusitis:


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