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.

Prevention
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