Acute Rhinosinusitis

Acute rhinosinusitis (ARS) is the medical term for what most people call a "sinus infection." This occurs when the lining of the sinuses becomes inflamed, resulting in swelling and blockage of the natural sinus drainage pathways. Symptoms usually include:

  • Nasal congestion
  • Nasal drainage
  • Facial pressure/pain
  • Decreased sense of smell
  • Cough
  • Low-grade fever
  • Ear discomfort

There are many factors that contribute to the development of acute rhinosinusitis. These include:

  • Viruses
  • Bacteria
  • Allergies
  • Environmental irritants

Most commonly, ARS is caused by a virus and symptoms will resolve after 10 days with home treatments or over-the-counter medications. In 2 to 5 percent of cases, symptoms will either worsen or persist beyond what is expected for a viral infection, and a bacterial infection may develop. Often, when a bacterial infection develops, the patient initially sees an improvement at days 3- 7, followed by an acute worsening of symptoms or persistent symptoms for more than 10 days with no improvement.

Acute rhinosinusitis is diagnosed by your ENT physician after taking your history and performing a physical exam. Sometimes, a nasal endoscopy is performed to help make the diagnosis. A nasal endoscopy provides the physician with extensive visualization of the nasal cavities and allows the physician to take a specimen in case a culture needs to be performed. Rarely, a CT scan of the sinuses may be recommended to definitively establish the diagnosis, as symptoms of sinusitis can often overlap and mimic other diseases.

Once acute rhinosinusitis is diagnosed, an appropriate antibiotic will typically be prescribed for 7-14 days. Depending on the severity of the infection, antibiotics may be used for longer periods of time and additional medications may also be prescribed, including steroids, medicated nasal sprays, and decongestants.

We recommend that patients with acute rhinosinusitis aid their recovery by:

  • Drinking plenty of fluids, this encourages mucus drainage and allows the sinuses’ natural defense mechanisms to function properly.
  • Nasal irrigation or saline lavages of the nasal cavities, these are helpful for physically removing retained mucus secretion and decrease swelling of the mucosal lining of the nasal passages. Your ENT physician will be happy to provide additional information about this process.

Important Information for Patients:

The American Academy of Otolaryngology has developed new guidelines for treatment of acute rhinosinusitis. These guidelines also include useful informational materials for patients. These materials will help patients understand symptoms, what to do when antibiotics should be used, and the best treatment methods for acute rhinosinusitis. Patients may wish to review the following useful information:

Clinical Practice Guidelines for Adult Sinusitis

Patient Information on Management of Adult Sinusitis

Diagnosing Sinusitis

Patient Information: Sinusitis

Recurrent Acute Rhinosinusitis

Sometimes, patients suffer from recurrent sinus infections that result in frequent trips to the doctor, missed time from school/work, and a decreased quality of life. When this occurs at least 4- 6 times per year with symptom-free intervals between infections, it is called recurrent acute rhinosinusitis (RARS). There can be many contributing factors to the development of this condition, including:

  • Exposure to frequent viral infections
  • Frequent air travel
  • Allergies
  • Environmental pollutants
  • Acid reflux
  • Genetic predisposition
  • Underlying medical conditions such as immunodeficiency
  • Anatomical factors or structural problems with the sinuses

If you believe you may have acute rhinosinusitis, or if you are suffering from other sinus and allergy problems, please contact us to schedule an appointment. Our ear, nose, and throat physicians will work with you to develop an individualized treatment plan tailored to fit your needs.