Rhinosinusitis is a very common condition of the upper respiratory tract. The disease may be caused by viral, bacterial or fungal infections as well as by allergens or air pollution (e.g. tobacco smoke), with viral infections being the most common cause. The first phase of viral rhinosinusitis therapy involves the use of antipyretics, analgesics, anti-oedematous agents as well as nasal decongestants, occasionally, topical glucocorticosteroids, nasal irrigation and adjunct phytotherapy. Viral or allergic rhinosinusitis does not require antibiotic therapy. Antibiotics should be used if symptoms persist after 7–10 days or bacterial superinfection develops. More intense treatment (antibiotic, metronidazole, intranasal glucocorticosteroid as well as formulations that dilute mucous secretions and have anti-oedematous effects) for up to several days is necessary in cases of acute rhinosinusitis in children, which is quite often a very serious disease bordering on sepsis (pansinusitis). According to the 2012 European Position Paper on Rhinosinusitis and Nasal Polyps 2012 (EPOS 2012), natural compounds may be used as an adjunct treatment in some cases and in certain periods of the disease. These include nasal irrigation with saline or an appropriate seawater solution as well as the use of herbal medicinal products. The paper discusses in detail the use of different herbal medicinal products and presents literature data related to the efficacy and tolerance of these products.

rhinosinusitis, diagnostic management guidelines, treatment, phytotherapy (as adjunct treatment)