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Rhinosinusitis most commonly known as sinusitis and occurs due to the inflammation of the mucous membranes lining of the paranasal sinuses (four pairs of cavities that connect the nose to the throat). The paransal sinuses include:

1. The maxillary sinuses which lie below the eyes in the cheeks
2. The ethmoid sinuses which lie between the eyes
3. The frontal sinuses lie above the eyes
4. The sphenoid sinuses lie posteromedial to the eyes

A cold or allergy usually creates the inflammation and congestion that prevents drainage of the warm, moist, mucus-filled sinus cavity. This creates a perfect breeding ground for viral, bacterial or fungal infections.

Rhinosinusitis can be either infectious or noninfectious:

• Infectious rhinosinusitis usually arise from a viral infection and is generally caused by bacterial growth.
• Noninfectious rhinosinusitis is usually the result of allergies or other non-viral irritants.

• Acute rhinosinusitis
  Acute rhinosinusitis is commonly caused by bacterial or viral infection which is followed an upper respiratory tract infection or a common cold. It can lasts for 3-4 weeks
• Recurrent acute rhinosinusitis
  Acute recurrent rhinosinusitis refers to repeated acute rhinosinusitis episodes occurring 4 or more times per year, for more than 2 years.
• Sub-acute rhinosinusitis
  Sub-acute rhinosinusitis is characterized by persistent symptoms of sinus inflammation which often lasts for 4-12 weeks.
• Chronic rhinosinusitis
  Chronic rhinosinusitis is characterized by symptoms that persist longer than 8-12 weeks.
  Chronic rhinosinusitis may also symbolize the presence of fungus in the nasal cavity that causes an immune response which results in the symptoms of chronic rhinosinusitis.

Rhinosinusitis is caused by a variety of underlying conditions including viral, bacterial or fungal growth or may be due to a self-perpetuating inflammatory process.

Rhinosinusitis commonly begins with a cold, which acutely obstructs the sinus outflow track because of mucosal swelling, followed by a bacterial sinus infection. Other common conditions which can cause rhinosinusitis include:

• Allergic and non-allergic rhinitis
• Anatomical abnormalities in the nose such as nasal septal defects
• Aspirin sensitivity, which may be suggested when patients present with co-existing asthma
• Immune system deficiencies, lack or inadequacy of immunoglobulins/antibodies

• Facial pain or pressure
• Nasal obstruction or blockage
• Purulence nasal discharge
• Discolored postnasal discharge
• Hyposmia or anosmia
• Long grade fever (for acute rhinosinusitis only)
• Difficulty breathing
• A decreased sense of smell
• Sneezing and wheezing

Minor symptoms of rhinosinusitis include:

• Headaches
• Halitosis
• Fatigue
• Dental pain
• Cough
• Ear pain