Recurrent acute rhinosinusitis is defined as 4 or more episodes of acute symptoms in one year, each lasting 7 to 10 days and with no symptoms to suggest chronic rhinosinusitis. Treatment Treatment for rhinosinusitis requires attention to not only the potential bacteria involved but also to the underlying inflammatory process occurring within the sinonasal passages. Patients with concurrent allergic symptoms should be treated with an antihistamine. In the absence of allergic symptoms, antihistamines have no role in the treatment of rhinosinusitis. Topical nasal steroids are better for prevention in the allergic patient but can be used as an adjunct in difficult to treat or chronic infections.
Antibiotic therapy is the mainstay of treatment once an infection has occurred.
Practitioners need to consider the prevelence of antibiotic resistence in their community before prescribing an antibiotic. Imaging studies For uncomplicated cases with a history suggestive of acute rhinosinusitis, imaging studies are not needed. In patients whom the diagnosis is still in question despite the history then imaging is appropriate. Standard plain film radiographs of the paranasal sinuses are the least expensive test available but in most health centers they have been replaced by a limited CT scan showing a few axial images of the sinuses. Patients exhibiting signs or symptoms of complications of rhinosinusitis should have a coronal CT scan performed.