I favor a step-wise approach for treating sinusitis. This approach starts with saltwater irrigations twice a day, in the morning and evening after brushing your teeth. I like to use the saying, “brush and flush.”

If additional treatment is necessary, the next step is over-the-counter medications such as antihistamines, decongestants and cold remedies, which may be of benefit. Nasal steroid sprays may be used by people who have allergies, but the use of decongestant nasal sprays is not recommended for more than three days. For persistent symptoms, antibiotics prescribed by a physician generally provide rapid symptomatic relief. More than 80 percent of patients with sinusitis are successfully treated with this step-wise approach. In more severe cases, however, surgery may be necessary.