Feature Article

The current management of rhinosinusitis

A. Simon Carney, Peter J Wormald



Most patients with acute or chronic rhinosinusitis respond well to appropriate medical management. However, surgery may be necessary in some cases.

Key Points

  • Most cases of acute rhinosinusitis are viral and will settle without the need for antibiotics.
  • Uncomplicated chronic rhinosinusitis may require directed antibiotics and two to three months of nasal corticosteroids and saline douches before medical management can be said to have failed.
  • In carefully selected patients, functional endoscopic sinus surgery will produce satisfactory outcomes in 85 to 90% of patients.
  • If complications develop or the patient is immunocompromised, urgent referral to an otolaryngologist is mandatory.
  • In the absence of facilities for CT scanning, plain sinus radiographs have a role in confirming the diagnosis.