The essentials
Recurrent acute rhinosinusitis refers to distinct bacterial sinus infections with recovery between episodes. Repeated colds and continuous chronic sinus symptoms are different patterns.
Separate episodes or never fully well?
Recurrent acute bacterial rhinosinusitis is commonly defined as four or more qualifying episodes in a year, with no symptoms between them. That number is a starting point for the history, not an indication for surgery by itself.
A cold can cause significant congestion, sore throat, cough and drainage. Bacterial sinusitis becomes more likely when compatible symptoms persist without improvement for at least 10 days, or worsen after initially improving. The course matters more than mucus color alone.
If symptoms never fully resolve, the evaluation may instead focus on chronic sinusitis, rhinitis or another condition.
Why timing the evaluation can help
A record of episode dates, symptoms, duration and treatments is helpful. Outside visit notes can add context, especially if antibiotics have been prescribed repeatedly. The goal is to establish what each episode represents.
Look for contributing problems
Allergy, nonallergic rhinitis, anatomy, migraine and repeated viral exposure can overlap with the story of recurring “sinus infections.” Selected patients need allergy or immune testing. The history and examination help decide which questions need answering.
Viral illnesses can be miserable. A sinus operation does not prevent the next cold, so confirming the diagnosis protects you from a treatment unlikely to solve the problem.
Choosing a treatment that fits
When recurrent bacterial disease and an appropriate anatomical target are documented, balloon dilation or endoscopic surgery may help selected patients. The choice depends on the involved sinuses, extent of disease, prior medical care and your goals.
Continued medical management or treatment of an underlying allergy may be the better route in other cases. Dr. Fewins explains the evidence supporting the diagnosis and what a procedure would—and would not—be expected to change.
Common questions
Does four infections a year mean I need surgery?
No. The episodes must first be evaluated as bacterial sinus disease, with an appropriate target and reason to expect benefit from a procedure.
Why not get the scan when I feel well?
For some questions that is appropriate. When the question is what happens during a recurring flare, imaging while symptomatic may be more informative.
Medical references
General education complements your individual evaluation.