Rhinosinusitis is a very common and often debilitating disease affecting approximately 1 in 10 people. Billions of dollars are spent annually on medical and surgical treatments for rhinosinusitis. Rhinosinusitis is defined as the inflammation of the mucosa of the paranasal sinuses and the nasal cavity. Various etiologies of sinusitis have been identified, including environmental (e.g., pollution/allergies, viral upper respiratory tract infections (URIs)), systemic (e.g., diabetes, HIV), and host issues (e.g., autoimmune diseases, cystic fibrosis). Regardless of the inciting event, the mucosal inflammation leads to obstruction of the paranasal sinus ostia, stasis of secretions, and often, superimposed bacterial infections. The causative organisms in the acute setting are usually Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis. The diagnosis of sinusitis requires at least two major symptoms including:

1. Facial pain/pressure.

2. Nasal congestion or obstruction.

3. Nasal discharge or purulence.

4. Anosmia or hyposmia.

5. Clinical finding of purulence in nasal cavity.

Or one major symptom and two minor:

1. Headache.

2. Fever.

3. Halitosis.

4. Dental pain.

5. Ear pain, pressure, or fullness.