Treatments and drugsBy Mayo Clinic staff
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|Endoscopic sinus surgery|
The goal of treating chronic sinusitis is to:
- Reduce sinus inflammation
- Keep your nasal passages draining
- Eliminate the underlying cause
- Reduce the number of sinusitis flare-ups you have
Treatments to relieve symptoms
Your doctor may recommend treatments to help relieve sinusitis symptoms. These include:
- Saline nasal irrigation, which you spray into your nose to rinse your nasal passages.
- Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase), budesonide (Rhinocort Aqua), triamcinolone (Nasacort AQ), mometasone (Nasonex) and beclomethasone (Beconase AQ).
- Oral or injected corticosteroids. These medications are used to relieve inflammation from severe sinusitis, especially if you also have nasal polyps. Examples include prednisone and methylprednisolone. Oral corticosteroids can cause serious side effects when used long term, so they're used only to treat severe symptoms.
- Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays. Examples of OTC oral decongestants include Sudafed and Actifed. An example of an OTC nasal spray is oxymetazoline (Afrin). These medications are generally taken for a few days at most; otherwise they can cause the return of more severe congestion (rebound congestion).
- Over-the-counter pain relievers such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others). Because of the risk of Reye's syndrome — a potentially life-threatening illness — never give aspirin to anyone younger than age 18. Some of these medications can make chronic sinusitis worse, so be sure to check with your physician before starting any pain reliever
- Aspirin desensitization treatment if you have reactions to aspirin that cause sinusitis. However, this treatment is usually available only in specialized clinics and medical centers.
Potentially more effective methods of delivering medications to the sinuses are being studied.
Antibiotics are sometimes necessary for sinusitis if you have a bacterial infection. However, chronic sinusitis is often caused by something other than bacteria, so antibiotics don't always help.
If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens may help treat the condition.
In cases that continue to resist treatment or medication, endoscopic sinus surgery may be an option. For this procedure, the doctor uses an endoscope, a thin, flexible tube with an attached light, to explore your sinus passages. Then, depending on the source of obstruction, the doctor may use various instruments to remove tissue or shave away a polyp that's causing nasal blockage. Enlarging a narrow sinus opening also may be an option to promote drainage.
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- Lalwani AK. Current Diagnosis & Treatment in Otolaryngology-Head & Neck Surgery. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=39. Accessed March 25, 2013.
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- Albu S. Novel drug-delivery systems for patients with chronic rhinosinusitis. Drug Design, Development and Therapy. 2012;6:125.
- Primary Amebic Meningoencephalitis (PAM): Prevention & control. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/naegleria/prevention.html. Accessed March 24, 2013.
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- Rudmik L, et al. Olfactory improvement after endoscopic sinus surgery. Current Opinion in Otolaryngology & Head and Neck Surgery. 2012;20:29.
- Fact sheet: 20 questions about your sinuses. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/sinuses.cfm. Accessed March 31, 2013.