Acute sinusitis is defined as symptomatic inflammation of the nasal cavity and paranasal sinuses lasting less than four weeks. The term "acute sinusitis" is preferred to "sinusitis" since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa.Approximately 0.5% of all upper respiratory tract infections are complicated by sinusitis; the incidence of acute sinusitis ranges from 15 to 40 episodes per 1000 patients per year, depending on the setting.1,2 It is much more common in adults than it is in children, whose sinuses are not fully developed.
The most common etiology of ARS is a viral infection associated with the common cold. Viral rhinosinusitis is complicated by acute bacterial infection in only 0.5 to 2.0 percent of episodes uncomplicated acute viral rhinosinusitis (AVRS) typically resolves in 7 to 10 days. Acute bacterial rhinosinusitis (ABRS) may also be a self-limited disease. Rarely, patients with untreated bacterial disease may develop serious complications. This topic will address the treatment of acute sinusitis.
Symptomatic therapy is indicated for both acute viral rhinosinusitis (AVRS) and acute bacterial rhinosinusitis (ABRS). Analgesics — Analgesics such as non-steroidal anti-inflammatories and acetaminophen are used for pain relief.Saline irrigation — Mechanical irrigation with buffered, physiologic, or hypertonic saline may reduce the need for pain medication and improve overall patient comfort, particularly in patients with frequent sinus infections. The evidence supporting use of saline irrigation is limited, but indicates possible benefits for symptom relief with minor adverse effects, including nasal burning and irritation.