Diagnosis and treatment of sinusitis

How can I get relief from Sinusitis? What is the treatment for Sinusitis?

 The primary objectives for treatment of sinusitis are reduction of swelling, eradication of infection, draining of the sinuses, and ensuring that the sinuses remain open.

1. Self-care for Sinusitis:

2. Medications:

Analgesics - used to reduce fever and relieve headache, toothache, and facial pain caused by infection or congestion in the sinuses.Over-the-counter pain relievers such as acetaminophen and ibuprofen can be used.

Decongestants – a decongestant to help your sinuses drain. Decongestants are for short-term use. Should not be used beyond their recommended use, usually four to five days, or they may actually increase congestion

Antibiotics – used for bacterial sinus infections. Your doctor may prescribe antibiotics when symptoms of sinusitis are severe and do not respond to home treatment, or complications (such as pus formation in sinus cavities) develop. Synthetic penicillin like amoxicillin is used most commonly.

Antibiotics may be prescribed sooner for:

• Children with nasal discharge, possibly with a cough, that is not getting better after 2 – 3 weeks
• Fever higher than 102.2° Fahrenheit (39° Celsius)
• Headache or pain in the face
• Severe swelling around the eyes

4. Surgeries for Sinusitis:

 It is performed endoscopically using a fiberoptic nasopharyngoscope.

• If antibiotics and other medicines are not effective in opening the sinus, surgery may be necessary. If there is a structural abnormality of the sinus such as nasal polyps, which can obstruct sinus drainage, surgery may be needed. Functional endoscopic sinus surgery (FESS) is the standard surgical treatment for sinusitis. This surgery removes anatomical and pathological obstructions associated with sinusitis.
• Emergency surgery is almost always necessary in patients who show signs that infection has spread beyond the nasal sinuses into the bone, brain, or other parts of the skull.
• Fungal infections must be diagnosed early followed by immediate surgical debridement, antifungal drugs (Amphotericin B) and stabilizing any underlying health problem. An ENT specialist can perform this surgery.
• In some cases a deviated nasal septum (wall between the nostrils that separates the two nasal passages) can interfere with the drainage of the sinuses, resulting in repeated sinus infections. Septoplasty is the surgical treatment to straighten a deviated septum.
• An abnormal communication (oro-antral fistula) between the oral cavity and the maxillary sinus results from foreign body or extruded root canal filling in the sinus. Long delay in its removal usually results in sinus infection. Cadwell-Luc operation is used for managing maxillary sinusitis, secondary to persistent oro-antral fistula. It is also used when longer-lasting drainage is necessary.