Treatment
After
diagnosing sinusitis and identifying a possible cause, a doctor can
prescribe a course of treatment that will reduce the inflammation and
relieve the symptoms.
Acute
sinusitis is treated by re-establishing drainage of the nasal passages,
controlling or eliminating the source of the inflammation, and relieving
the pain. Doctors generally recommend decongestants to reduce the
congestion, antibiotics to control a bacterial infection, if present,
and pain relievers to reduce the pain.
Over-the-counter and prescription decongestant nose drops and sprays,
however, should not be used for more than a few days. When used for
longer periods, these drugs can lead to even more congestion and
swelling of the nasal passages.
Most
patients with sinusitis that is caused by bacteria can be treated
successfully with antibiotics used along with a nasal or oral
decongestant. An antibiotic that fights the bacteria most commonly
associated with sinusitis is the initial treatment recommended.
Many
cases of acute sinusitis resolve without antibiotics. However, patients
with underlying allergic disease, and infectious sinusitis, need to be
treated to relieve their allergy symptoms. Patients with asthma and
infectious sinusitis often have exacerbations of asthma which need to be
treated. Many physicians feel that some patients with severe asthma have
dramatic symptom improvement when their chronic sinusitis is treated
with antibiotics.
Doctors
often prescribe steroid nasal sprays, along with other treatments, to
reduce the congestion, swelling, and inflammation of sinusitis.
Chronic
sinusitis is often difficult to treat successfully, as symptoms persist
even after prolonged courses of antibiotics. In general, the treatment
of chronic sinusitis, such as with antibiotics and decongestants, is
similar to treatment of acute sinusitis. However, the role of bacterial
infections, and hence the usefulness of antibiotics in treating chronic
sinusitis, is debated. Steroid nasal sprays are commonly used to reduce
inflammation in chronic sinusitis. Although these nasal sprays are
occasionally used for long-term treatment for patients with chronic
sinusitis, the long-term safety of these medications, especially in
children, is not fully understood, and the benefits and risks need to be
balanced. For patients with severe chronic sinusitis, a doctor may
prescribe oral steroids, such as prednisone. Because oral steroids can
have significant side effects, they are prescribed only when other
medications have not been effective.
Although
sinus infection cannot be cured by home remedies, people can use them to
lessen their discomfort. Inhaling steam from a vaporizer or a hot cup of
water can soothe inflamed sinus cavities. Another treatment is saline
nasal spray, which can be purchased in a pharmacy. A hot water bottle;
hot, wet compresses; or an electric heating pad applied over the
inflamed area also can be comforting.
When
medical treatment fails, surgery may be the only alternative for
treating chronic sinusitis. Studies suggest that the vast majority of
patients who undergo surgery have fewer symptoms and better quality of
life. In children, problems often are eliminated by removal of adenoids
obstructing nasal-sinus passages. Adults who have had allergic and
infectious conditions over the years sometimes develop nasal polyps that
interfere with proper drainage. Removal of these polyps and/or repair of
a deviated septum to ensure an open airway often provides considerable
relief from sinus symptoms. The most common surgery done today is
functional endoscopic sinus surgery, in which the natural openings from
the sinuses are enlarged to allow drainage. This type of surgery is less
invasive than conventional sinus surgery and serious complications are
rare.
Treatments for
chronic sinusitis include:
-
Antibiotics.
Chronic sinusitis may require a long period of antibiotic treatment.
You may need to take antibiotics for a minimum of 3 weeks, and up to
12 weeks, or until you've been symptom-free for 7 days.
-
Corticosteroids.
If you have intense inflammation of your sinuses, your doctor may
prescribe a corticosteroid. Doctors commonly prescribe nasal
corticosteroid sprays, but severe inflammatory sinusitis may require
oral corticosteroids. Your doctor may prescribe corticosteroid pills
to try to shrink the inflamed sinus membranes, then recommend a
corticosteroid nasal spray to prevent them from swelling again.
If your condition
doesn't improve with medications, your doctor may recommend surgery.
Surgically enlarging a narrow sinus passage or removing a bone or polyp
that's blocking a passage will allow better drainage, making an
infection less likely. Your doctor may perform surgery using a thin,
flexible tube called an endoscope.
There are many
treatments available to help fight sinusitis and sinus infections. Once
you are diagnosed with a form of sinusitis, your doctor may recommend
one of the following (and in some cases, a combination of the
following):
Oral
Antibiotics:
There are over a dozen antibiotics that can be prescribed to help fight
sinusitis, with the most popular being Amoxicillin (a form of
Penicillin). Oral antibiotic treatments consist of taking a specific
amount of antibiotic pills 2-3 times a day for up to two weeks. The
problem with oral antibiotic treatments is that the distribution in the
sinuses is very poor. In addition, some people can experience side
effects like dizziness or nausea.
Nasal Sprays:
Nasal steroid sprays and nasal saline irrigations may be recommended to
help contain and reduce the inflammation of your sinuses.
IV:
IV is the process of treating a sinus infection intravenously.
Antibiotics are injected into a vein, which then enter the blood stream.
Surgery:
If other treatments fail, the final attempt to resolve a serious sinus
problem is usually surgery. The sinus surgery is usually conducted
through the nose with the purpose of draining the sinuses, removing
diseased tissue, resolving the conflict, and improving the drainage and
health of the sinuses. There is a lot of preparation that goes into a
surgery including a CT scan of the patient to find out which sinus areas
need to be treated. Thanks to modern advances, micro-telescopes have
made it possible to do most sinus surgeries without incisions. Still,
the surgery can take 1-2 hours and may require a hospital stay for one
night.
Chronic sinusitis
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