Last reviewed: 21 Aug 2021
Last updated: 19 Aug 2021

Summary

Definition

History and exam

Key diagnostic factors

  • symptoms <10 days (acute viral sinusitis)
  • symptoms >10 days but <4 weeks (acute bacterial sinusitis)
  • symptoms that worsen after an initial improvement (acute bacterial sinusitis)
  • purulent nasal discharge
  • nasal obstruction
  • facial pain/pressure
  • severe symptoms at onset (acute bacterial sinusitis)
  • dental pain

Other diagnostic factors

  • cough
  • myalgia
  • sore throat
  • hyposmia
  • edematous turbinate
  • fever

Risk factors

  • viral upper respiratory tract infection
  • allergic rhinitis
  • GERD

Diagnostic investigations

Investigations to consider

  • nasal endoscopy
  • sinus culture
  • CT sinuses (noncontrast)
  • x-ray sinuses
  • MRI
  • lateral neck x-ray

Treatment algorithm

Contributors

Authors

Gordon H. Sun, MD, MSc
Gordon H. Sun

Chief Medical Information Officer

Chief of Otolaryngology

Rancho Los Amigos National Rehabilitation Center

Downey

CA

Disclosures

GHS is a consultant with Partnership for Health Analytic Research, LLC, Guidepoint, and Gerson Lehrman Group, Inc. for medical research and expert opinion work. GHS is also a consultant with MAXIMUS, Inc. for independent medical reviews.

Acknowledgements

Dr Gordon H. Sun would like to gratefully acknowledge Dr Melissa A. Pynnonen and Dr Joseph K. Han, previous contributors to this topic.

Disclosures

MAP and JKH declare that they have no competing interests.

Peer reviewers

Benjamin S. Bleier, MD

Instructor of Otology and Laryngology

Harvard Medical School

Massachusetts Eye and Ear Infirmary

Department of Otolaryngology - Head and Neck Surgery

Boston

MA

Disclosures

BSB is a co-founder and equity shareholder in Luxxeal, Inc.

Christos Georgalas, MD, PhD, DLO, FRCS (ORL-HNS)

Assistant Professor/Consultant

Academic Medical Center

Amsterdam

The Netherlands

Disclosures

CG declares that he has no competing interests.

Use of this content is subject to our disclaimer