Chronic rhinosinusitis affects up to 1 in 10 people. It is generally defined as an inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer.


  • Incidence: 500.00 cases per 100,000 person-years
  • Peak incidence: 30-40 years
  • Sex ratio: 1:1
Condition Relative
Chronic rhinosinusitis1
Nasal polyps0.20
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+


Predisposing factors include:
  • atopy: hay fever, asthma
  • nasal obstruction e.g. Septal deviation or nasal polyps
  • recent local infection e.g. Rhinitis or dental extraction
  • swimming/diving
  • smoking

Clinical features

  • facial pain: typically frontal pressure pain which is worse on bending forward
  • nasal discharge: usually clear if allergic or vasomotor. Thicker, purulent discharge suggests secondary infection
  • nasal obstruction: e.g. 'mouth breathing'
  • post-nasal drip: may produce chronic cough


Management of recurrent or chronic sinusitis
  • avoid allergen
  • intranasal corticosteroids
  • nasal irrigation with saline solution

Red flags symptoms
  • unilateral symptoms
  • persistent symptoms despite compliance with 3 months of treatment
  • epistaxis