The treatment of sinusitis depends on the cause. Utilizing information from the history of the patient's symptoms in conjunction with information from the highly specialized office diagnostic nasal endoscopy, we can often narrow down the possible causes of the patient's sinusitis. When we think of ways to treat sinusitis, we like to categorize them into nonsurgical treatment options and surgical treatment options. We always try non-surgical treatments first. This can include over the counter medications, such as decongestants, antihistamines, and nasal sprays or irrigations. These are commonly used for viral sinusitis or allergic sinusitis. Prescription medications, such as topical antihistamine or steroid nasal sprays or irrigations may be used as well. When severe inflammation or polyps are identified, short courses of oral steroids may be prescribed. When bacterial infections are identified, oral or topical antibiotics are commonly utilized as well. The diagnostic nasal endoscopy allows a sinus specialist like me to not only assess a patient's response to therapies, but address more difficult cases where an infection may not be responding to antibiotics by culturing or growing the bacteria in the lab to figure out which antibiotics are best suited to treat the particular infection. When we've exhausted non-surgical options and symptomatic sinusitis persists, we may consider a procedure to open the sinuses. This accomplishes several goals. Firstly, it widens the drainage pathways for sinuses allowing the sinuses to better clear their contents. Second, it allows us to clean the sinuses by removing disease, thick inflamed tissue and mucus, debris, pus, and whatever else might be stuck inside the sinuses. Lastly, having bigger openings to the sinuses allows many of the medical therapies I discussed earlier to penetrate deeper into the nasal and sinus cavities and more effectively control the inflammation.
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