| Antibiotics. The primary treatment for acute sinusitis is | | | | intranasal corticosteroid sprays may be extremely |
| antibiotics for eradicating infection. A prolonged course | | | | helpful in reducing inflammation. Beclomethasone, |
| is often needed because the blood supply to bony | | | | budesonide, fluticasone, flunisolide, and triamcinolone are |
| areas such as the sinuses is limited. This course may | | | | available in the United States. Intranasal cromolyn |
| vary but a typical treatment takes three weeks. | | | | sodium may also help these patients. An intranasal |
| Establishing Drainage In sinus disease it is crucial to | | | | preparation of nedocromil sodium should be available |
| establish good drainage, which is often achieved with | | | | soon. Should You Consider Surgery? In patients who |
| decongestants such as pseudoephedrine. | | | | suffer from persistent sinus infections despite courses |
| Antihistamines can also help, particularly in allergic | | | | of appropriate antibiotics, a surgical drainage procedure |
| patients, but may not be a good idea for many | | | | may be needed. A sinus CAT scan documenting the |
| asthmatics owing to the risk of drying up the bronchial | | | | presence of infection and maximal medical therapy |
| secretions. To avoid excessive dryness, | | | | should have been given before surgery. When |
| decongestants are often combined with an | | | | possible, this surgery is increasingly performed through |
| expectorant such as guaifenesin. A saline nasal spray | | | | the endoscope. The technique is less traumatic than |
| may help rinse out dried secretions and add moisture | | | | older sinus drainage procedures and is often |
| to dry membranes. Treating Chronic SinusitisEven | | | | performed in an outpatient setting. Physicians must |
| after a sinus infection has been eradicated, many | | | | individualize treatment of sinus disease for each |
| patients will continue to experience congestion, pain, | | | | patient. Aggressive treatment of sinus disease, |
| and recurring bouts of sinus infection. In patients with | | | | however, may also improve the control of bronchial |
| chronic disease, particularly allergic ones, adding | | | | asthma. |