In cases of viral sinusitis, topical and/or systemic steroids with nasal rinses/sprays may be all that’s needed to reduce mucosal swelling and relieve obstruction of the sinus openings (ostia). Antibiotics are typically reserved for severe infections or in cases of obvious bacterial infection in order to fight the bacteria causing the problem.
Overall, the first line treatment of sinusitis is medication.
It is important to realize that chronic sinusitis is exactly what it sounds like: a chronic condition! The mainstay of sinusitis treatment is topical medication delivery. Sinusitis occurs due to an exaggeration of mucosal inflammation that leads to bacterial overgrowth. Topical steroids help to prevent this inflammation before it gets out of control. Many patients are able to achieve good control of sinusitis symptoms simply with a daily medication regimen.
Unfortunately, there have been some studies showing at least 20% of patients do not respond adequately to medications.1-3
After medical therapy has been attempted, a candidate may have 3 options, depending on the extent and severity of their sinus disease and their ENT’s recommendation:
- Continue medical therapy
- In-Office Balloon Sinuplasty procedure
- Go to the operating room (OR) for surgery under general anesthesia
- Subramanian, H., et al. A Retrospective Analysis of Treatment Outcomes and Time to Relapse after Intensive Medical Treatment for Chronic Sinusitis. Am J Rhinol 2002; 16(6): 303-312.
- Hessler, J., et al. Clinical outcomes of chronic rhinosinusitis in response to medical therapy: Results of a prospective study. Am J Rhinol 2007; 21(1): 10-18.
- Lal, D., Scianna, J., Stankiewicz, J. “Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure.” Am J Rhinol Allergy 23, 396-400, 2009.