Treatments for Sinusitis

Sinusitis—also known as rhinosinusitis—is defined as an inflammation of the sinuses that results in a number of painful, irritating symptoms. If the sinusitis lasts for less than four weeks, it is diagnosed as acute sinusitis. If it lasts longer, it is defined as chronic sinusitis.

A number of factors can lead to sinusitis, including abnormal nose structure, infections, allergies, and air pollution. It is more likely to persist in those with asthma, chronic illnesses, weak immune systems, and cystic fibrosis. X-rays are rarely conducted to diagnosis sinusitis, as it can be clearly and accurately diagnosed through other means. However, if complications as a result of sinusitis are suspected, an X-ray may be needed.

It is very common, affecting approximately thirty million US citizens each year. But chronic sinusitis affects only about 12.5% of all people, and is much more common in older people than younger people, which may indicate a link to overall health and age. 

Though not as dangerous or life-threatening as many other serious ailments, and serious complications are rare, sinusitis takes a heavy toll on the quality of one’s life, inflicting the loss of thousands of man-hours. The run-of-the-mill sinus infection that goes away as quickly as it comes may not require a visit to the doctor. The sinus infection that lasts all of three weeks, which is symptomatic of an acute attack, can cause a considerable disruption of one’s work and normal routine and may require urgent medical attention.

The most dangerous complication of sinusitis arises from the sinuses' proximity to the brain. If the inflammation spreads to the brain, there can be disastrous results. Abscesses and meningitis are some of the very dangerous complications that can follow from brain inflammation. It is therefore wise to seek medical help even when you are unsure if the symptoms you are displaying are characteristic of sinusitis. Early diagnosis is the best way to ensure a safe and healthy full recovery, without any of the potential complications. 

The symptoms of sinusitis include these:

• Headaches
• Post-nasal drip
• Thick nasal discharge
• Dizziness

Common methods of preventing sinusitis include these:

• Immunization
• Consistent hand-washing
• Avoiding smoking

The most common treatments of sinusitis involve simply waiting for it to pass, or using antibiotics, nasal irrigation, antihistamines, and nasal sprays. Read on to find out about the more specific methods of treating sinusitis and when they can and should be used. 

I. Treatments That Can Be Followed Up at Home

1. Mitigating Pain and Controlling Fever

Tylenol and Ibuprofen are excellent over-the-counter remedies for lessening the pain and discomfort of a sinus infection, and for bringing down fever. As a precaution, however, avoid taking these medicines if you suffer from liver or kidney disease. Some people develop allergies to pain relievers such as acetaminophen, and therefore should consult their general practitioner for alternative medicines. For more substantial cases in which antibiotics are recommended by your doctor, amoxicillin-clavulanate is the most commonly administered. 

2. Nasal Spraying to Relieve Congestion

Proper breathing ensures that the inhaled air is warmed, moisturized and kept free of allergens and foreign particles. Sinus infections through viruses and bacteria cause excessive drainage of mucus. If the mucus gets blocked in the nose, it can back up into the sinuses and worsen the infection.

A good nasal spray keeps the airways moist and lubricated, and allows excess mucus to be drained out. Avoid using sprays for longer than a week at a time, and switch over to manual inhalation of mildly medicated and steamed water. Nasal sprays that have a decongestant factor, like oxymetazoline, are the most common nasal sprays. 

3. Applying a Hot Compress to the Cheeks

Add a drop of tea tree oil, eucalyptus, or peppermint to warm water and soak a small towel in it. Squeeze the towel to drain excess water and apply the warm cloth to the cheeks. The soothing warmth and the volatile herbal oils help in liquefying the phlegm and draining the airways. This isn't recommended as a permanent cure; although it subdues symptoms, it does nothing to actually rid one of the inflammation.

4. Washing the Nasal Passages

Boil and cool water and set aside. To the water, add one measure of salt and an equal quantity of sodium bicarbonate, which has good pH-balancing properties. Standing over a wash basin, cup the lukewarm water in your palms and sniff the water through the nostrils. The saline solution acting along with baking soda flushes the nasal passages, removes excess mucus, and speeds up air circulation. Repeat till you get favorable results, and prepare a fresh solution each day. This is recommended on an occasional basis even when one isn't suffering from sinusitis. 

II. Symptoms Compelling You to Seek Medical Advice

If home treatment does not give adequate relief from distressful symptoms, and the infection extends beyond a week, do not hesitate to seek a qualified medical opinion.

1. Steroidal Treatment for Inflammation

Sometimes, infection and inflammation do not subside within a week of taking painkillers and anti-inflammatories, and the condition progresses from acute to chronic. In acute and chronic conditions, steroidal sprays (e.g. mometasone furoate monohydrate) may be recommended for use for up to a month, or sometimes more depending on the degree of tissue inflammation. Common side effects of steroidal spray use include irritations to the nose and throat such as cough and sore throat.

2. Antibiotics for Bacterial Infections

Although most sinusitis cases are viral and therefore do not require antibiotics, a powerful broad spectrum antibiotic such as amoxicillin-clavulanate (Augmentin) is useful in terminating many of the bacterial infections that cause sinusitis. Penicillin-intolerant individuals may require other antibiotics such as ciprofloxacin. The treatment needs to continue for at least two weeks, or for a longer period if the infection is particularly serious and deep-set. Stomach upsets and dysentery are common side effects of antibiotic treatments. Taking probiotic solutions containing Lactobacillus rhamnosus will help soothe the tummy upsets. For these with severe allergies to penicillin, fluoroquinolones can be administered instead. 

3. Surgical Solutions for Sinusitis

When sinusitis is chronic or constant, your general practitioner may refer you to an otolaryngologist, who may then recommend surgery as a form of permanent treatment. However, this is a last resort that should be used only if medication has consistently had no effect on the sinusitis. 

Structural abnormalities that block the airways and nasal polyps that obstruct normal mucus flow can come in the way of total relief. These issues may prolong the discomfort of sinusitis despite the best medical care. It is now possible to correct structural abnormalities of the airways through functional endoscopic sinus Surgery or FESS.

In this procedure, a surgeon sends an endoscope up the nasal passage under general anesthesia. A camera enables a 3D visualization of the inner spaces, while a fiber optic light shows the way during surgery. Nasal polyps and other outgrowths can be removed in this manner.

In balloon catheter dilation, or balloon sinuplasty, a miniature balloon-like device is inflated to widen narrowed passages and clear airways of accumulated debris. In this manner, it dilates the sinus passageways to clear them up.