Sinusitis is defined as an inflammation of the mucous membrane lining the paranasal sinuses (Fig. 1). Sinusitis can be classified chronologically into five categories (1):

  • acute sinusitis;
  • recurrent acute sinusitis;
  • subacute sinusitis;
  • chronic sinusitis;
  • acute exacerbation of chronic sinusitis (AECS).

Acute sinusitis is a new infection that may last up to four weeks and can be subdivided symptomatically into severe and non-severe.

Recurrent acute sinusitis is diagnosed when four or more episodes of acute sinusitis, which all resolve completely in response to antibiotic therapy, occur within one year.

Subacute sinusitis is an infection that lasts between 4 and 12 weeks, and represents a transition between acute and chronic infection.

Chronic sinusitis is diagnosed when signs and symptoms last for more than 12 weeks. AECS occurs when the signs and symptoms of chronic sinusitis exacerbate but return to baseline following treatment.

The infant is born with mainly the maxillary and ethmoid sinuses present. The sinuses develop gradually throughout childhood and reach full development during adolescence. The frontal sinuses rarely become infected before six years of age.

Sinuses are involved in most cases of viral upper respiratory tract infection (URTI), but sinus infection usually does not persist after the nasal infection has subsided.

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