How is sinusitis treated?

Acute sinusitis

There are over the counter medicines that can relieve some of the symptoms associated with sinusitis. i.e. headaches, pressure, fatigue and pain. Usually these are a combination of some kind of antihistamine along with decongestant or pain reliever.

Seeing a doctor will usually result in a prescription for antibiotics and a recommended rest. Furthermore, there have been studies that have concluded allergy testing results in detection of inhaled allergens that lead to inflammation which can trigger sinusitis.

Therapeutic measures range from the medicinal to the traditional and may include nasal irrigation or jala neti using a warm saline solution, analgesics (such as aspirin, paracetamol (acetaminophen) or ibuprofen), hot drinks including tea and chicken soup, inhaling steam, over-the-counter decongestants and nasal sprays, and getting plenty of rest. If sinusitis doesn't improve within 48 hours, or is causing significant pain, a doctor may prescribe antibiotics (Amoxicillin usually being the most common) or nasal steroids.

Chronic sinusitis

Simple measures
Nasal irrigation and flush promotes sinus cavity health, and patients with chronic sinusitis including symptoms of facial pain, headache, halitosis, cough, anterior rhinorrhea (watery discharge) and nasal congestion found nasal irrigation to be just as effective at treating these symptoms as the drug therapies.

Recently the introduction of pulsatile irrigators specifically for sinus irrigation have been reported best for nasal irrigation In other studies, daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis, and is recommended as an effective adjunctive treatment of chronic sinonasal symptoms. and irrigation is recommended as an effective adjunctive treatment of chronic sinonasal symptoms.

Medical approaches
For chronic or recurring sinusitis, referral to an otolaryngologist may be indicated for more specialist assessment and treatment, which may include nasal surgery.

A relatively recent advance in the treatment of sinusitis is a type of surgery called FESS - functional endoscopic sinus surgery, whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis.

This replaces prior open techniques requiring facial or oral incisions and refocuses the technique to the natural openings of the sinuses instead of promoting drainage by gravity, the idea upon which the Caldwell-Luc surgery was based.

Another recently developed treatment is Balloon Sinuplasty™. This method, similar to balloon angioplasty used to "unclog" arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner. Its final role in the treatment of sinus disease is still under debate but appears promising.

Fungus

Based on the recent theories on the role that fungus may play in the development of chronic sinusitis, newer medical therapies include topical nasal applications of antifungal agents. Much of the original research indicating fungus took place at the Mayo Clinic and they have since patented this treatment option. Although there are some licensing battles taking place over these drugs as a result of the patent, they are currently available for other uses and therefore can be compounded by pharmacies or even by the patient.

Surgical Approach
The surgical approach to the paranasal sinuses depends on the particular sinus which needs a surgical intervention and on the particular type of manipulation necessary.