Test Your Knowledge

Treatment of rhinosinusitis depends on whether the problem is acute or chronic.

• Acute rhinosinusitis often resolves on its own without the need for treatment. However, antibiotics may be recommended for patients with moderate or severe symptoms. These drugs help shorten the duration of the condition and also reduce its severity. A course of antibiotics over 10 days to two weeks is usually successful in curing an infection caused by bacterial rhinosinusitis. Decongestants may be prescribed to open the sinuses and reduce the volume of mucus that is present. Hypertonic saline sinus washes are also very effective and commonly used. 
  
  
• Chronic rhinosinusitis can be more difficult to treat. Many medications may be necessary to successfully treat this condition. These medications may include antibiotics for three weeks or longer (when bacterial infection is involved), decongestants, mucus–thinning medications, and antihistamines or anti-inflammatory corticosteroid nasal sprays (both of which are used to reduce swelling and mucus production). For patients using nasal sprays, physicians may recommend a saltwater or saline wash be used before the spray to help remove mucus and bacteria from the nose and sinuses. Normal saline is the most commonly used type of saline. However, hypertonic saline also serves as a good sinus wash. 
  
  In some cases, allergy shots (immunotherapy) may be helpful in reducing sensitivity to certain allergens for people with allergic rhinosinusitis.

For some patients, surgery may be necessary to treat chronic rhinosinusitis. This is more common in adults with a physical abnormality that is responsible for symptoms, such as nasal polyps (small, grape-like growths), crookedness in the wall dividing the nostrils (deviated septum) or another physical problem. It may also be used as a last resort when medications have failed. In functional endoscopic sinus surgery, the natural openings of the sinuses are enlarged to facilitate drainage. Serious complications are rare in this procedure.

In children, the removal of nose and throat lymphoid tissue known as the adenoids often eliminates the blockage causing problems.

Patients who suffer from some forms of fungal rhinosinusitis also require surgery to remove the fungus and prevent damage to the sinus, eyeball or brain.

Over-the-counter pain relievers may also be recommended. The drugs help relieve sinus headaches caused by either form of rhinosinusitis and lessen fever. Always consult with a physician before taking any medication.

Some physicians may recommend non-drug treatments to help soothe symptoms associated with chronic rhinosinusitis. These techniques, which keep nasal passages moist, include:

• Inhaling hot, moist air – such as from steaming water in a bowl – for 10 minutes two to four times a day. Patients should wear a towel over their heads to prevent steam from escaping.
  
  
• Applying hot packs to the face. This helps ease facial pain.
  
  
• Rinsing nasal cavities with buffered salt water. This can help remove mucus and bacteria from the nose and sinuses.