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Chronic Sinusitis
Alternate Names : Chronic Rhinosinusitis, Chronic Frontal Sinusitis
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What are the treatments for the condition?
Treatment for chronic sinusitis caused by allergies includes:
taking antihistamines, such as diphenhydramine, loratadine or fexofendadine
taking decongestants, such as pseudoephedrine.
using saltwater rinses
using topical nasal corticosteroids, such as fluticasone or beclomethasone
avoiding allergens
undergoing allergy desensitization
Treatment for chronic bacterial sinusitis includes appropriate antibiotics such as amoxicillin/clavulanic acid. Chronic infection is usually caused in adults by Staphylococcus aureus and anaerobic bacteria, or bacteria that cannot live in an environment with oxygen. In children, the bacteria are the same in both acute and chronic infections. In addition to antibiotics, nasal steroids, saltwater rinses, decongestants, and mucus-thinning agents are helpful.
For people who do not respond to these treatments and who have structural problems, surgery is the next step in management. The goal of surgery is to reestablish the normal routes of drainage and remove all areas of infection. After surgery:
90% of people report improvement in their headaches.
85% have reduced postnasal drainage.
more than 70% recover the sense of smell.
What are the side effects of the treatments?
Side effects depend on the different treatments used. With surgery, complications are infrequent. There is a very rare occurrence of tear duct injury, a disturbance in vision, or leak of spinal fluid.
What happens after treatment for the condition?
With successful medical and surgical treatment, symptoms are usually controllable and infections can be reduced.
How is the condition monitored?
Monitoring depends on the symptoms. However, any person with progressively worsening symptoms or eye involvement needs to seek immediate medical care.
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Author: William Stevens, MD Reviewer: H. William Kelly, PharmD Date Reviewed: 03/13/01
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