The goal of treating chronic sinusitis is to:
- Reduce sinus inflammation
- Keep your nasal passages draining
- Eliminate the underlying cause
- Reduce the number of sinusitis flare-ups
Treatments to relieve symptoms
These treatments include:
- Saline nasal irrigation, with nasal sprays or solutions, reduces drainage and rinses away irritants and allergies.
Nasal corticosteroids. These nasal sprays help prevent and treat inflammation. Examples include fluticasone (Flonase, Veramyst), triamcinolone (Nasacort 24), budesonide (Rhinocort), mometasone (Nasonex) and beclomethasone (Beconase AQ, Qnasl, others).
If the sprays aren't effective enough, your doctor might recommend rinsing with a solution of saline mixed with drops of budesonide (Pulmicort Respules) or using a nasal mist of the solution.
- Oral or injected corticosteroids. These medications are used to relieve inflammation from severe sinusitis, especially if you also have nasal polyps. Oral corticosteroids can cause serious side effects when used long term, so they're used only to treat severe symptoms.
- Aspirin desensitization treatment, if you have reactions to aspirin that cause sinusitis. Under medical supervision, you're gradually given larger doses of aspirin to increase your tolerance.
Antibiotics are sometimes necessary for sinusitis if you have a bacterial infection. If your doctor can't rule out an underlying infection, he or she might recommend an antibiotic, sometimes with other medications.
If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body's reaction to specific allergens might improve the condition.
In cases resistant to treatment or medication, endoscopic sinus surgery might be an option. For this procedure, the doctor uses a thin, flexible tube with an attached light (endoscope) to explore your sinus passages.
Depending on the source of obstruction, the doctor might use various instruments to remove tissue or shave away a polyp that's causing nasal blockage. Enlarging a narrow sinus opening also may be an option to promote drainage.