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

An inflammatory process of the nasal passages and sinus cavities involves the paranasal sinuses in inflammation.

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

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


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

Repeated 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, decreased pH levels, and 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 four 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 rhizoidal sinusitis throughout the year. We are presenting four or more episodes per year.

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

On the other hand, chronic rhinosinusitis is often the result of allergies or even the presence of fungi.


Rhinosinusitis can usually be diagnosed based on the physical examination findings 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 of being related to allergies, an evaluation of the allergies will be carried out to determine the allergens causing the symptoms and avoid 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. It causes other conditions, such as the appearance of nasal polyps, abnormal tissue growth in the paranasal sinuses, and sleep apnea, among others.

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

The objective of the surgical treatment is to restore the health of the breast, correct the mucosa’s difficulty in restoring the mucociliary elimination system and return to 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. 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 a significant cause of morbidity; it is associated with increased 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 complete or moderate relief of the symptoms, improving the patient’s quality of life.