Nasal cavity, paranasal sinuses, nasopharynx
Inflammatory / idiopathic / autoimmune
Chronic rhinosinusitis

Topic Completed: 1 March 2015

Revised: 21 August 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Chronic rhinosinusitis[TI] nasal

Jihong Sun, M.D.
Margaret S. Brandwein-Weber, M.D.
Page views in 2018: 4,296
Page views in 2019 to date: 3,911
Cite this page: Sun J, Brandwein-Weber M. Chronic rhinosinusitis. website. Accessed September 17th, 2019.
Definition / general
  • Chronic inflammation of the nasal cavity (rhinitis) or the paranasal sinuses (sinusitis), symptoms lasting more than 6 weeks
  • Sequel to acute rhinitis (symptoms lasting 6 weeks or less), with development of secondary bacterial infection
  • Associated with deviated septum or nasal polyps; also ulceration and infection extending into sinuses
Essential features
  • Thickened, hyalinized basement membrane (minimal criteria) directly beneath respiratory epithelium and around seromucinous glandular tubuli
  • Rhinosinusitis, sinusitis
  • Most common health problem in the United States
  • Unilateral or bilateral, nasal cavity or paranasal sinus
  • Associated with deviated septum or nasal polyps
  • Ostial obstruction in osteomeatal compex causes anaerobic overgrowth
  • Allergy, vasomotor (constricted or dilated vessels), infection, diabetes mellitus, cystic fibrosis, Kartagener syndrome, aspirin intolerance, Churg-Strauss disease, nickel exposure
Clinical features
  • Facial pain, pressure, congestion or fullness; nasal obstruction, blockage, discharge or purulence
  • Aeration or drainage, ensuring ostial patency
Microscopic (histologic) description
  • Thickened basement membrane (minimal criteria) directly beneath respiratory mucosa and around seromucinous glandular tubuli
  • Increased lymphoplasmacytic infiltrate
  • Goblet cell hyperplasia and papillary hyperplasia
  • Squamous metaplasia can be seen and is associated with cigarette exposure
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Margie Brandwein-Gensler, M.D.
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Sinonasal polyps

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Chronic rhinosinusitis

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A. Papillary hyperplasia
B. Thickened basement membrane

Images hosted on other servers:
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Chronic sinusitis

Differential diagnosis
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