Sinusitis, most especially if it is already a chronic condition will already require medical intervention. However, it will still depend on the type of sinusitis as well as the cause. You can buy over-the-counter drugs – without doctor’s prescription to help relieve the pain, or congestion. But these will not cure the sinusitis itself. Antihistamines can even worsen the condition because it can dry the mucus.
Sinusitis, when caused by a virus will usually resolve at most within 14 days. Taking of medications will usually be recommended by a doctor after a week or two. It is still best to consult your healthcare provider before taking any medication. Self-medication is strongly not advised since it can impose further harm to your body.
The doctor will usually do several physical examinations first before prescribing the proper medical treatment. He will check for tenderness of the facial bones and the color of the discharge. He may use nasal endoscopy to detect if there structural problems in the nasal septum or the presence of polyps.
When it becomes difficult to view through endoscopy, imaging techniques such as Computed Tomography (CT) scanning will give the doctor a proper view of the paranasal sinuses. Doctors were using x-rays before CT scans came into common use. However, they are not very accurate. MRI or Magnetic Resonance Imaging is not commonly used because CT scan is much more efficient in determining abnormalities of the nasal cavity.
Before giving antibiotics, the doctor may recommend a sinus puncture and bacterial culture to determine what type of bacteria is causing the inflammation of the sinuses. This is an invasive procedure wherein a needle is used to withdraw fluid and culture the bacteria for proper antibiotic to be used.
A broad-spectrum antibiotic (a type of antibiotic that can kill a wide range of bacteria) can be given. The problem with antibiotics is that there are side effects. The most common is gastrointestinal distress. For women, it can cause vaginal infections. Allergic reactions can also occur most especially to those who are hypersensitive to penicillin and sulfamides. Drug interactions can also happen if you are taking other medications other than the antibiotic.
Corticosteroid in a form of nasal spray is given to someone with chronic sinusitis. If nasal sprays did not work, doctors may give oral corticosteroids such as prednisone, which is also helpful to those who have allergic fungal sinusitis. However, corticosteroids can mask the presence of fever, which could indicate other infections.
Antibiotic therapy is stopped if there is no progress after a month or two. If this happens, surgery is most likely to be an option. Surgery can clear the sinuses to facilitate drainage of the trapped fluids. Inserting a drainage tube is the most common approach and using sterile water to flush out the mucus. If in case polyps are causing the sinusitis, Functional Endoscopic Sinus Surgery (FESS) is recommended. This will correct the obstructions, ventilate the patient and at the same time drain the sinuses. This type of procedure can be rare but serious complications such as leakage of cerebrospinal fluid (fluid that is in the brain) which can result to meningitis, or vision problems.
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