Acute Rhinosinusitis (Sinus Infection) Treatment, Raleigh, NC

Acute rhinosinusitis (ARS) is the medical term for what most people call a "sinus infection." This is occurs when the lining of the sinuses become inflamed, resulting in swelling and blockage of the natural sinus drainage pathways. Symptoms usually include nasal congestion, nasal drainage, facial pressure/pain, decreased sense of smell, and may also include cough, low-grade fever, and ear discomfort.

There are many factors that contribute to the development of acute rhinosinusitis, including viruses, bacteria, allergies, and other environmental irritants. Most commonly, ARS is caused by a virus and symptoms will resolve after 10 days with conservative treatments, such as home and/or over-the-counter remedies for the "common cold." About 2-5% of the time, symptoms will either worsen or persist beyond what is expected for a viral infection, and a bacterial infection develops. Often, this presents as an initial improvement in symptoms at day 3-7 followed by an acute worsening in symptoms, or as a persistence of symptoms beyond 10 days with no improvement.

Acute rhinosinusitis is diagnosed by your Capitol ENT physician after taking your history and performing a physical exam. Sometimes, nasal endoscopy is performed to help make the diagnosis and for proper visualization in case a culture specimen needs to be taken. Rarely, a CT scan of the sinuses may be recommended to definitively establish the diagnosis, as symptoms of sinusitis can often overlap with and mimic other disease processes.

Once acute rhinosinusitis is diagnosed, an appropriate antibiotic will typically be prescribed for 7-14 days. Depending on the severity of the infection, antibiotics may be used for longer periods of time and adjunctive medications may also be prescribed, including steroids, medicated nasal sprays, and decongestants. As with any general illness, we recommend adequate hydration and fluid intake, which will encourage mucus drainage and allow the natural defense mechanisms of the sinuses to function properly. Saline lavages of the nasal cavities are also helpful to physically remove retained mucus secretion and decrease swelling of the mucosal lining of the nasal passages.

Sometimes, patients suffer from recurrent sinus infections that result in frequent trips to the doctor, missed time from school/work, and a decreased quality of life. When this occurs at least 4- 6 times per year with symptom-free intervals between infections, it is called recurrent acute rhinosinusitis (RARS). There can be many contributing factors to the development of this condition, including exposure to frequent viral infections, frequent air travel, allergies, environmental pollutants, acid reflux, a genetic predisposition, an underlying medical conditions like an immunodeficiency, and anatomical factors. Your Capitol ENT physician will help you identify these factors and recommend the appropriate medical and/or surgical treatment.