A general approach to patients with chronic sinusitis includes nasal saline flushes, intranasal steroids, and a prolonged course (at least 3 weeks) of a broad-spectrum antibiotic . In approximately half of patients with chronic sinusitis, patients are found to have positive skin tests to airborne allergens. Given this very high prevalence of allergy in chronic sinusitis, it seems worth-while to do allergy testing in all patients with this condition. If the results show that the patient is allergic to an avoidable allergen, particularly a year-around allergen such as house dust mites, indoor pets, and indoor mold, aggressive allergen avoidance measures should be started promptly.
A small number of clinical studies suggest that allergy vaccine therapy (allergy shots) may be helpful in reducing the severity of chronic sinusitis, and most physicians will start a trial of this treatment in patients with relevant positive skin tests. If this initial program of allergen avoidance, medications, and possibly immunotherapy is not successful after a several-week trial, endoscopic sinus surgery may be employed to remove diseased mucosal tissue, particularly from the very narrow drainage tracts that empty from the sinuses into the nose.
Overall Treatment Approach to Chronic Sinusitis
- Nasal irrigation
- Intranasal steroids
- Oral antibiotics
- Allergen avoidance and immunotherapy (if allergic)
Susan’s comment:
I’ve had allergies most of my life. When I was a child, it was mostly during the spring and summer months. As I got older, the symptoms seemed to stretch out through the whole year, mostly with a stuffy nose and a drip in my throat. Over the last 2 years, I’ve been having sinus infections, where the mucus turns green and I have a bad cough and headache. This happens every 2 or 3 months, and I have to get an antibiotic from my doctor. For the past 6 months, I’ve been taking a nasal spray called Veramyst every day. I still have some nasal congestion, but the repeated infections have become less frequent, and overall I feel much better.
Endoscopy
Examination of the body’s interior through an instrument inserted into a natural opening or an incision.