Chronic Rhinosinusitis Treatments
Chronic sinusitis is a condition which last 12 weeks or longer despite attempts at treatment. When the air-filled spaces in and around the nose called sinuses become inflamed, chronic rhinosinusitis can ensue. There are many causes but it seems that there is a connection between nasal allergies and sinusitis. The sinuses naturally produce mucous which drains through small openings called ostia into the nasal cavity. These ostia are lined by the same mucosa that lines the inside of the nose. When the lining becomes inflamed, the ostia can become blocked. This causes mucous to build up in the sinuses creating a great breeding ground for bacteria. These bacteria cause more inflammation blocking the sinuses even further.
There are several treatments for chronic rhinosinusitis. Home remedies such as nasal saline irrigation, over-the-counter medications such as antihistamines and decongestants, and prescription medications such as antibiotics can be used together to create a medical management. The goal of any management strategy is to not only control the current outbreaks but also to prevent future recurrence with good allergy treatment.
Several studies have shown the efficacy of nasal saline rinses. One of the best known rinses is the Neti pot although several other brands have been marketed. In some cases, nasal saline irrigation is better than certain prescription medications at controlling nasal allergies. These rinses are a combination of salt and water and are poured into the nose. This allows for a removal of the offending allergen as well as improving the natural microscopic hairs which move mucous in the nose.
Nasal saline rinses can be combined with prescription or over-the-counter antihistamine treatments. In certain patients, particularly those who suffer from asthma in addition to allergies, leukotriene inhibitors can be used to augment the antihistamines.
For patients with either acute sinusitis or chronic sinusitis, a course of antibiotics may be necessary to kill off bacterial overgrowth and return to hemostasis to the nasal system. If a patient has been on antibiotics and several times, antibiotic resistance may be a concern and more powerful antibiotics may need to be used.
For patients with several episodes of sinusitis within a fairly short period of time or an extended chronic rhinosinusitis, surgery may be necessary to improve the natural drainage system in the nose. The latest technology and sinus surgery allows for the use of balloon technology to open the natural ostia in an office setting with local anesthesia in appropriate patients.
