Symptom Onset
Sinus symptoms begin — pressure, congestion, discharge, placeholder text.
- Viral URI: Common triggers (most frequent cause)
- Abrupt: Onset pattern (hours to 1–2 days)
- 4: Cardinal symptoms (pressure, congestion, discharge, smell loss)
- 28 days: Acute cutoff (defines acute window)
What triggers onset
Placeholder: viral infection usually starts the cascade.
Placeholder key insight about onset speed.
Early symptom pattern
Placeholder: pressure and congestion appear first.
Why duration matters
Placeholder: duration anchors the whole diagnostic pathway.
Duration Timeline Tracked
Days since onset accumulate, placeholder short lead text here.
- Days: Tracking unit (converted to weeks)
- 4–12 wk: Subacute range (transitional zone)
- ≥4 / yr: Recurrent ARS (episodes definition)
- 84 days: Chronic cutoff (12-week threshold)
Why track days precisely
Placeholder: duration drives classification, not severity alone.
Placeholder insight on timeline precision.
The subacute zone
Placeholder: 4–12 weeks is a watchful transition period.
Recurrence vs chronicity
Placeholder: repeated acute bouts differ from true chronic disease.
4-Week & 12-Week Threshold
The timeline crosses two decision thresholds, placeholder lead text.
- < 4 wk: Acute threshold (clinical diagnosis only)
- 4–12 wk: Subacute threshold (monitor closely)
- > 12 wk: Chronic threshold (imaging required)
- 2: Branch decision points (4-week and 12-week gates)
The 4-week gate
Placeholder: crossing 4 weeks flags watchful monitoring.
Placeholder insight on the branch logic.
The 12-week gate
Placeholder: crossing 12 weeks mandates chronic workup.
Why thresholds are fixed
Placeholder: consensus guidelines standardize these cutoffs.
Diagnostic Workup Diverges
Acute stays clinical; chronic needs endoscopy and CT, placeholder text.
- Clinical: Acute workup (history and exam only)
- Endoscopy + CT: Chronic workup (objective confirmation)
- Mucosal thickening: Key CT finding (seen past 12 weeks)
- Nasal polyps: Key endoscopy finding (chronic subtype marker)
Acute clinical diagnosis
Placeholder: symptoms and exam suffice for acute cases.
Placeholder insight on avoiding unneeded imaging.
Chronic imaging requirement
Placeholder: CT and nasal endoscopy confirm chronic disease.
What imaging reveals
Placeholder: mucosal thickening and polyps signal chronicity.
Divergent Treatment Outcomes
Acute resolves with short-course care; chronic needs specialists, placeholder.
- Short-course: Acute treatment (symptomatic, self-limited)
- Long-term: Chronic treatment (specialist-managed)
- ~10 days: Acute resolution (typical course)
- ENT: Chronic referral (specialist workup needed)
Acute outcome path
Placeholder: most acute cases self-resolve without antibiotics.
Placeholder insight on acute prognosis.
Chronic outcome path
Placeholder: chronic disease needs long-term specialist management.
Why pathways diverge
Placeholder: duration-driven pathology explains differing care.