Treatment

After diagnosing sinusitis and identifying a possible cause, your healthcare provider can suggest various treatments.

Acute Sinusitis

If you have acute sinusitis, your healthcare provider may recommend

• Antibiotics to control a bacterial infection, if present
• Pain relievers to reduce any pain
• Decongestants to reduce congestion

Even if you have acute sinusitis, your provider may choose not to use an antibiotic because many cases of acute sinusitis will end on their own. But if you do not feel better after a few days you should contact your provider again.

You should use over-the-counter or prescription decongestant nose drops and sprays only for few days. If you use these medicines for longer periods, they can lead to even more congestion and swelling of your nasal passages.

If you have an allergic disease along with sinusitis, you may also need medicine to control allergies. This may include a nasal steroid spray that reduces the swelling around the sinus passages and allows the sinuses to drain. If you already have asthma and then get sinusitis, your asthma may worsen. You should stay in close touch with your healthcare provider to modify your asthma treatment if needed.

Chronic Sinusitis

Healthcare providers often find it difficult to treat chronic sinusitis successfully. The two main forms of treatment that are used, nasal steroid sprays and long courses of oral antibiotics, alone or in combination, have not been rigorously tested in chronic sinusitis. Scientists need to do more research to determine what the best treatment is.

Many healthcare providers also recommend using saline (saltwater) washes or sprays in the nose to help remove thick secretions and allow the sinuses to drain.

If you have severe chronic sinusitis, your healthcare provider may prescribe oral steroids, such as prednisone. Because oral steroids are powerful medicines and can have significant side effects, you should take them only when other medicines have not worked.

Surgery

When medicine fails, surgery may be the only alternative for treating chronic sinusitis. The goal of surgery is to improve sinus drainage and reduce blockage of the nasal passages. During surgery, which is usually done through the nose, the surgeon

• Enlarges the natural opening of the sinuses
• Removes any polyps
• Corrects significant anatomic deformities that contribute to the obstruction

Most people have fewer symptoms and better quality of life after surgery. In a substantial number of people, however, problems can recur after surgery, sometimes even after a short period of time.

In children, surgeons can sometimes eliminate sinus problems by removing adenoids (tissue in the back of the throat) that obstruct the nasal-sinus passages.