Page Summary
- Recurrent acute rhinosinusitis means repeated, separate episodes of acute sinusitis with symptom-free periods in between.
- It is different from chronic sinusitis, where symptoms persist between episodes.
- Evaluation looks for factors that may contribute to repeated episodes.
- Treatment depends on the frequency, severity and pattern of the episodes and any underlying cause.
Recurrent Acute Rhinosinusitis
Recurrent acute rhinosinusitis means four or more distinct episodes of acute sinusitis in one year, with the nose and sinuses returning to normal between episodes.
That symptom-free interval is what separates it from chronic rhinosinusitis, where symptoms persist between flare-ups rather than clearing completely.
Why do the episodes keep happening?
Repeated episodes sometimes point to something that makes the sinuses more vulnerable. Contributing factors can include:
- The shape of the nose and sinuses, such as a deviated septum or narrow sinus drainage pathways.
- Allergic or non-allergic rhinitis.
- Dental disease involving an upper tooth next to the sinus — see odontogenic sinusitis.
- Problems affecting the immune system.
- Smoking or other irritant exposure.
In many patients no single cause is found. The aim then becomes reducing how often episodes happen and how severe they are.
How is it assessed?
Assessment is far more useful when each episode has actually been confirmed rather than assumed, so a simple record of your symptoms, their timing, and any treatment given is genuinely helpful to bring with you.
Evaluation may include nasal endoscopy, CT imaging of the sinuses, assessment for allergy, and, in selected patients, testing for immune or other contributing problems.
Imaging is most informative when it is done during or shortly after an episode, or when it is being used to plan treatment. A scan taken during a completely symptom-free interval may look normal even when episodes are genuinely recurring.
Treatment
Each episode is treated on its own. Antibiotics are not automatically needed for every episode — the same criteria apply as in a single episode of acute sinusitis, and The Common Cold — When Do I Need Antibiotics? explains the timing in detail.
Between episodes, treatment focuses on whatever is contributing: allergy treatment, saline irrigation, nasal steroid sprays, dental treatment, or stopping smoking.
Sinus surgery may be considered when episodes continue despite appropriate medical treatment and there is a problem that surgery can improve. It is not a routine treatment for recurrent infections on its own.
Important: Repeated courses of antibiotics without a confirmed diagnosis are worth avoiding. If you are having what seem to be frequent sinus infections, it is worth having the pattern properly assessed rather than treating each episode by phone.