Sinusitis is an inflammation of the membrane lining the paranasal sinuses what cause an excessive production of mucus. This mucus accumulation has as a consequence the accumulation of viruses, bacteria, and fungus that cause infection. There are different things that can cause sinusitis, especially those occupying the nasal cavity such as nasal polyps, deviated nasal septum, among others.
There are a lot of alternatives to treat sinusitis that can range from symptomatic treatment to surgery. The key to treatment is discovering and stopping the cause. In many cases, the basis of treatment includes drinking plenty of fluids, nasal saline washes, nasal decongestant sprays, antihistamines, and topical nasal corticosteroids.
Nasal saline washes are very useful to liquefy and clear thickened secretions from nostrils. Likewise, topical nasal decongestants can be used for three or four days to reduce inflammation of the nasal mucosa, which in turn helps to drain out the accumulated mucus on paranasal sinuses. The reasons why topical nasal decongestants must be used for few days are: to avoid the called “rebound phenomenon”, which consists in a paradoxical obstruction of the nostrils when they are used, and to avoid the development of addiction.
It is important to remember that over-the-counter drugs must be used carefully because in some cases they can contain drying agents that only produce the mucus accumulation into the paranasal sinus.
When the cause of sinusitis is allergic, the patient requires antihistamines to solve the problem. Antihistamines are drugs able to oppose the activity of allergy mediators (specifically the histamine receptors) in the body. It is also important to determine the allergens and to avoid them, so in some cases, allergy tests can be needed.
On the other hand, topical nasal sprays with corticosteroid are much recommended in patients with nasal polyposis because they can help to reduce their size and prevent the occurrence of new polyps.
To ease discomfort some patients may need to take painkillers like ibuprofen or acetaminophen; however, they can’t be used for more than 10 days. Likewise, if the symptoms persist for more than a couple of days despite using the previously mentioned treatment, it is important to visit a qualified doctor in order to get an adequate diagnosis and treatment.
When the patient develops bacterial or fungus over-infection the doctor can prescribe antibiotics or antifungals for a period between ten and fourteen days (maybe for more time in chronic sinusitis). Most used antibiotics include amoxicillin and amoxicillin-clavulanate, in patients allergic to penicillin, cefaclor, loracarbef, clarithromycin, azithromycin, sulfamethoxazole, trimethoprim, and ciprofloxin can be used.
Surgery is reserved for those cases when the medical treatment has failed. This treatment is usually performed by an otolaryngologist in Houston. The goal of surgery is repairing the anatomical deformities like fixing defects in the bone separating the nasal passages, removing nasal polyps, opening closed nostrils, among others. According to the patient’s needs, the procedure can be performed under local or general anesthesia, and as an outpatient procedure. Surgery is especially useful in patients with chronic sinusitis or recurrent episodes of acute sinusitis.
In conclusion, there are many sinuses treatment available, and each one of them should be chosen according to each patient’s needs and the doctor’s recommendations.