Chronic Sinusitis often requires a complex combination of surgical and medical treatments.

Medical Therapy

A variety of medications are prescribed for sinusitis patients including oral (systemic) steroids, nasal steroid sprays, antibiotics, decongestants, and antihistamines. Due to their anti-inflammatory properties, steroids in particular are prescribed to treat the inflamed sinuses.4,5,6

Although nasal steroids are widely used, their application as a nasal spray is difficult to direct, and the amount of steroid actually delivered to the sinuses is unclear.7,8 Oral steroids carry the risk of serious side effects, including negative effects on the cardiovascular system, cataract formation in the eyes, weight gain, mood disorders and difficulty in controlling blood glucose levels in patients with diabetes.9

Sinus Surgery

In cases that persist despite medication, endoscopic sinus surgery may be an option. The goal of the surgery is to enlarge the inflamed or obstructed sinus passageways. The Ear, Nose, and Throat (ENT) surgeons access the sinuses through the nasal opening using a small telescope, an endoscope, for visualization. They enlarge the sinus passageways using surgical instruments which remove inflamed bone and tissue and dilate the sinus openings.

In the weeks following surgery, surgeons usually schedule frequent postoperative visits to clean the sinus cavities and ensure that they are open, healing well and without scarring. If there are signs of recurrent inflammation or scar formation, they may prescribe oral steroids and/or cut away obstructive scars. Reducing scarring and inflammation following surgery has been shown to lead to better long-term outcomes and reduce the need for revision surgery.10