Rhinosinusitis can be acute or chronic, if the duration of symptoms is less than or greater than 12 weeks, respectively. If chronic, it is classified as chronic rhinosinusitis with nasal polyps or chronic rhinosinusitis without nasal polyps.
Pain in chronic rhinosinusitis without polyps is very uncommon except in cases of exacerbation. In chronic rhinosinusitis with polyps, pain is even more rare, with the predominant symptoms in this case being nasal obstruction and absence of sense of smell.
To the contrary, pain in acute rhinosinusitis is usually severe and unilateral, and if it affects the maxillary sinus, it can also include toothache.
The presence of pain in rhinosinusitis is a cause for concern as the active bacterial infection can lead to complications if left untreated (abscess of the orbit, meningitis, brain abscess).