Rhinosinusitis natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]


Acute rhinosinusitis is a self-limiting disease. However, rarely acute and chronic rhinosinusitis can be complicated by extension of the infection to the surrounding structures, such as the eyes and brain.

Natural History, Complications and Prognosis

Natural History

Acute viral and bacterial rhinosinusitis are mostly self-limiting diseases, which resolve within 4 weeks. Rarely, acute bacterial sinusitis may be complicated by extension of the infection to the surrounding organs like theeye and the brain.[1] If left untreated, chronic rhinosinusitis may be complicated by periorbital cellulitis, brain abscess and epidural abscess.[2]



The prognosis for acute viral and uncomplicated bacterial rhinosinusitis is excellent. The majority of morbidity and mortality seen in cases of rhinosinusitis result from its complications.[7]


  1. Hwang PH (2009). "A 51-year-old woman with acute onset of facial pressure, rhinorrhea, and tooth pain: review of acute rhinosinusitis". JAMA. 301 (17): 1798–807. doi:10.1001/jama.2009.481. PMID 19336696.
  2. 2.0 2.1 Brook I (2005). "Microbiology of intracranial abscesses and their associated sinusitis". Arch. Otolaryngol. Head Neck Surg. 131 (11): 1017–9. doi:10.1001/archotol.131.11.1017. PMID 16301376.
  3. Worrall G (2011). "Acute sinusitis". Can Fam Physician. 57 (5): 565–7. PMC 3093592. PMID 21642737.
  4. Brook I (2009). "Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management". Int. J. Pediatr. Otorhinolaryngol. 73 (9): 1183–6. doi:10.1016/j.ijporl.2009.01.020. PMID 19249108.
  5. Sultész M, Csákányi Z, Majoros T, Farkas Z, Katona G (2009). "Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006". Int. J. Pediatr. Otorhinolaryngol. 73 (11): 1507–12. doi:10.1016/j.ijporl.2009.04.027. PMID 19500861.
  6. Heran NS, Steinbok P, Cochrane DD (2003). "Conservative neurosurgical management of intracranial epidural abscesses in children". Neurosurgery. 53 (4): 893–7, discussion 897–8. PMID 14519222.
  7. Bayonne E, Kania R, Tran P, Huy B, Herman P (2009). "Intracranial complications of rhinosinusitis. A review, typical imaging data and algorithm of management". Rhinology. 47 (1): 59–65. PMID 19382497.

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