BOYAN HADJIEV, MD Specializing in Adult & Pediatric Allergy, Asthma, Sinusitis Diplomate, American Board of Allergy & Immunology

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	Address: 30 East 40th Street (Btwn Madison and Park) Suite 1101 New York, NY 10016 Phone: 212-679-1200 Fax: 212-679-3495

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	Directions: Click here for map Subway: to Grand Central - 42nd Street to 42nd Street - Bryant Park

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Sinusitis Treatment

How is Sinusitis treated?

After diagnosing sinusitis and identifying a possible cause, your doctor can suggest treatments that will reduce your inflammation and relieve your symptoms.

In cases of acute sinusitis - your doctor may recommend:

• Topical or oral decongestants to reduce congestion
• Antibiotics to control a bacterial infection, if present
• An oral corticosteroid, to decrease congestion and inflammation, and help the antibiotic work better.

In our office, it is common practice to give all patients a “sinusitis flow sheet”, which they follow strictly. Patients should avoid using over the counter decongestant nose drops for longer than 5 to 7 days, as they can lead to even more congestion and swelling. Patient commonly refer to this phenomenon as “addiction” to nose sprays.

Many cases of acute sinusitis will spontaneously resolve without antibiotics. If you have allergic disease along with infectious sinusitis, however, you may need medicine to relieve your allergy symptoms also. If you are a patient who suffers from asthma, keep in mind that an acute sinus infection usually worsens asthma symptoms, and can

Chronic sinusitis treatment

Doctors often find it difficult to treat chronic sinusitis successfully, realizing that symptoms persist even after taking antibiotics for a long period. In our office, we have to become really creative in devising different methods getting the medication to its site of action. In general, treating chronic sinusitis is no different than treating acute sinusitis with antibiotics and decongestants. Because inflammation plays such an important role in chronic sinusitis, doctors also add topical corticosteroid nasal sprays (e.g. Flonase, Nasonex, Nasacort AQ, Rhinocort AQ, Veramyst, Omnaris) which are used daily. Depending on the origin and predisposing factors, oral prednisone or methylprednisolone (Medrol dose pack) can be added.
Also, various combinations of oral antihistamines and leukotriene modifiers (Singulair, Zyflo) can be used. In our office, we have devised a method of direct, concentrated delivery of topical corticosteroid drops to the sinuses, thereby reducing the overall need for oral corticosteroids.
Because oral corticosteroids tend to have a wide range of side effects, it is prudent to use them with caution. In many severe cases, however, oral corticosteroid preparations are absolutely essential for proper resolution of the sinus infection.

Patients with moderate to severe asthma may have dramatic improvement of their symptoms when their chronic sinusitis is treated with antibiotics, lending more support for the “one airway” hypothesis.

Home Remedies

Although home remedies cannot cure a sinus infection, they might give you some comfort. Inhaling steam from a vaporizer or a hot cup of water can soothe inflamed sinus cavities. Numerous studies have demonstrated the effectiveness saline nasal sprays or rinses (Netti-pot or commercially available preparations) when used as part of a general sinus care routine. Gentle heat applied over the inflamed area can also be very comforting. There are numerous folk remedies used for sinusitis too.

Surgical treatment

When medical treatment fails, sinus surgery may be the only alternative for treating chronic sinusitis. Research studies suggest that the vast majority of people who undergo surgery have fewer symptoms and better quality of life.
In children, sinus infections can often be eliminated by removal of adenoids obstructing nasal-sinus passage drainage.

Nasal polyps which are more prevalent in people with allergies or chronic sinus infections can also interfere with sinus drainage, thereby leading to repeat bouts of sinusitis. 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 sinus surgery done today is functional endoscopic sinus surgery (FESS), in which the natural openings from the sinuses are enlarged to allow proper drainage. This type of surgery is less invasive than conventional sinus surgery, and serious complications are rare.