Acute sinusitis is defined as symptomatic inflammation of the nasal cavity and paranasal sinuses lasting less than four weeks. The term "rhinosinusitis" is preferred to "sinusitis" since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa.The most common etiology of ARS is a viral infection associated with the common cold. 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.
Meeting a medical practitioner
The goals of treatment for acute rhinosinusitis (ARS) are different, depending on whether the source of infection is viral or bacterial. Distinguishing viral from bacterial ARS is discussed separately. AVRS is expected to resolve within 10 days. ABRS may also resolve spontaneously within the first 10 days. Patients, who present with fewer than 10 days of symptoms, in the absence of high fever or symptoms suggesting complicated illness, should be managed with supportive care . Management of acute viral rhinosinusitis (AVRS) aims to relieve symptoms of nasal obstruction and rhinorrhea; treatment does not shorten the clinical course of the disease.
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. Studies evaluating topical glucocorticoids should be interpreted with caution, as many studies contain both heterogeneous patient populations (acute, chronic, and/or viral rhinosinusitis) and different treatment regimens (concomitant decongestant, saline irrigation, antibiotic).