The first line of treatment for chronic sinusitis is medical management which our physicians have helped to write and which are based in part on our physicians’ research, have recommended that chronic sinusitis patients be aggressively treated with appropriate medical management prior to considering endoscopic surgery. Our physicians focus on providing evidence-based treatments that are tailored to patients’ needs and preferences. Our treatments are aimed at maximizing how well our patients feel using only medications. However, for those patients whose symptoms are not controlled with medications, our physicians use the latest research to identify the patients who could benefit from surgical treatments.
Our evidence-based, patient-centric treatment philosophy is grounded in a belief that physicians should be able to provide patients with the evidence and rationale for any treatment recommendation.
Medicines for sinusitis may include:
Inhaled corticosteroid medicine. Nasal sprays, drops or irrigations with steroids are often prescribed. These medications may be recommended for long-term usage, in which case your doctor will discuss the possibility of side effects (although intranasal corticosteroids are generally very well tolerated).
Saline rinses for the nose.
Sometimes antibiotic medicines are given if there is evidence of infection.
Sometimes steroids are given by mouth if the swelling in the nose and sinuses is severe.
Allergy medications. Antihistamines and allergy shots (immunotherapy) may be recommended if your doctor feels that allergies are contributing to your chronic sinusitis.
Biologic medications. Recently FDA approved medications directly target the inflammatory chemicals that lead to the development of nasal polyps in chronic sinusitis.
Other medicines. There are many other adjunctive medications that exist for chronic sinusitis.
The application and utilization of such medications is performed in a personalized, case-by-case manner.
If medical treatments are not enough to control your symptoms of chronic sinusitis, you may be a good candidate for endoscopic sinus surgery. Previous studies have established parameters for patients who may most benefit from endoscopic sinus surgery, and our providers can discuss these with you. The extent of surgery depends on the severity of the chronic sinusitis and which sinuses are involved. Your doctor will tell you more about your options. During endoscopic sinus surgery, the doctor uses a small camera (endoscope) to navigate inside the nose and sinuses, and to open the sinuses while removing diseased tissue (like polyps) and eradicating infection. This surgery is minimally invasive and is done without incisions on the face.
We have found that:
- Our average patient reports a pain level of five out of 10 at its worst after endoscopic sinus surgery.
- 60-70% of our patients can control their pain with just Tylenol after surgery.
- Endoscopic sinus surgery is generally very well tolerated by patients, so for those who meet evidence-based criteria as appropriate surgical candidates, surgery is an effective treatment modality to consider.
It’s important to treat the factors that may contribute to exacerbation or worsening of chronic sinusitis. If you have allergies, talk with your doctor about treatment. Our physicians are also experts in allergies and can help. If you are exposed to nasal irritants such as sawdust, use a filter mask. If you smoke, ask your doctor for help with quitting. Smoke irritates the sinuses and can make your sinus problems worse. If you live with smokers, ask them to consider quitting or only smoking outdoors.