Rhinosinusitis: Causes, Symptoms, Types, Diagnosis, Treatment and Risk Factors

It is an inflammatory process of the nasal passages and sinus cavities which involves the paranasal sinuses in the process of inflammation.

Chronic sinusitis is commonly accompanied by inflammations related to the respiratory tract at the nasal level and is often preceded by rhinitis symptoms .

That is why currently to describe this condition more accurately, the term chronic rhinosinusitis (RSC) is used.


The role of bacteria in the pathogenesis of chronic rhinosinusitis is currently being reassessed.

Repeated and persistent sinus infections can develop in people with severe acquired or congenital immunodeficiency states or cystic fibrosis .

Among the factors that can contribute to inflammation include the following:

  • Conditions such as allergy, infections and other immunological disorders.
  • Intrinsic factors of the upper airway.
  • Presence of proteins produced by bacteria (Superantigens).
  • The permanent presence of fungi that incite and maintain eosinophilic inflammation.
  • Presence of metabolic anomalies such as rejection of aspirin.

All these factors can cause the stagnation of secretions, the decrease of pH levels and the oxygen tension within the breast.

All this creates a favorable environment for the growth of bacteria which, in turn, contributes to an increase in the inflammation of the mucosa.


Symptoms of rhinosinusitis include:

  • Congestion, obstruction, runny nose and malaise.
  • Presence of pain in the head, ears and molars.
  • Decreased sense of smell
  • Purulence in the nasal cavity and fever.
  • Bad breath (halitosis)
  • Children are likely to have a cough.


Rhinosinusitis can manifest itself in three types of clinical syndromes:

  1. With nasal polyps.
  2. Without nasal polyps.
  3. Allergic fungal.

There is another classification according to the duration of the rhinosinusitis:

  • Acute : The duration of symptoms is less than 4 weeks.
  • Subacute : The duration of symptoms is between 4 and 12 weeks.
  • Chronic : The duration of symptoms is more than 12 weeks.
  • Recurrent : They are frequent episodes of rhinoidal sinusitis throughout the year. Presenting four or more episodes per year.

Acute rhinosinusitis very often occurs after you have fallen ill with a cold virus or have had an infection of the upper respiratory tract.

Chronic rhinosinusitis on the other hand is often the result of allergies or even the presence of fungi.


Rhinosinusitis can usually be diagnosed based on the findings of the physical examination and the symptoms presented, supported by nasal endoscopes and radiographs.

The presence of infections warrants the completion of other tests such as cultures with a sample obtained from the breast of the drainage and computerized tomography to help them determine the type and extent of infection, to guide the choice of antibiotics.

If this condition is suspected to be related to allergies, an evaluation of the allergies will be carried out to determine the allergens that are causing the symptoms, avoiding their contact.


The recommended treatment for rhinosinusitis varies, and is aimed at controlling predisposing factors, treating infections, facilitating drainage of secretions and reducing tissue edema.

In case of bacterial infections antibiotics will be prescribed, in case of analgesic pain such as paracetamol or ibuprofen, in case of inflammation decongestants such as pseudoephedrine, topical steroids or nasal irrigation are recommended, in case of allergies it is treated with antihistamines such as Claritin, Zyrtec or Allegra .

Untreated rhinosinusitis affects the quality of life of the patient and causes other conditions, such as the appearance of nasal polyps , abnormal tissue growth in the paranasal sinuses, sleep apnea, among others.

When the condition is due to functional problems caused by the lining of the mucosa, functional endoscopic sinus surgery (CSEF) is chosen.

The objective of the surgical treatment is to restore the health of the breast, correcting the difficulty of the mucosa to restore the mucociliary elimination system and returning normal sinus ventilation.

Risk factor’s

Studies reveal that one in eight people experience rhinosinusitis, so it is likely that you will experience this condition, if you are particularly exposed to a risk factor.

Some of these factors are : smoking, advanced age, activities such as diving and frequent air travel where you are subjected to changes in pressure, swimming, suffering from asthma and allergies, dental problems or a weakened immune system.

Because of its persistent nature, rhinosinusitis can become an important cause of morbidity, it is associated with an increase in asthma conditions and complications in the case of meningitis and brain abscesses.

The treatment for chronic rhinosinusitis and functional endoscopic sinus surgery give satisfactory results, with a complete or moderate relief of the symptoms, improving the quality of life of the patient.