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goal of treatment is to eliminate infection and encourage
the sinuses to drain. Temporary use of decongestants and corticosteroid
nasal sprays may promote drainage. These treatments cause
blood vessels in the nasal passages and sinuses to constrict,
which reduces inflammation.
Side effects associated with overuse of decongestants
include dizziness, headache, elevated heart rate, nervousness,
and insomnia. Steroid sprays are known to cause headache,
nasal irritation, and nosebleed. Use of decongestants is not
recommended in patients with high blood pressure or thyroid
problems. Decongestants use can also lead to physical dependence.
Bacterial sinusitis: Therapy for bacterial
sinusitis should include an appropriate antibiotic. If you
have three or more symptoms of sinusitis (see chart), be sure
to see your doctor for diagnosis.
In addition to an antibiotic, an oral or nasal
spray or drop decongestant may be recommended to relieve congestion,
although you should avoid prolonged use of nonprescription
nasal sprays or drops. Inhaling steam or using saline nasal
sprays or drops can help relieve sinus discomfort.
Antibiotic Resistance
Antibiotic resistance means that some infection-causing
bacteria are immune to the effects of certain antibiotics
prescribed by your doctor. Antibiotic resistance is making
even common infections, such as sinusitis, challenging to
treat.
You can help prevent antibiotic resistance.
If the doctor prescribes an antibiotic, it is important that
you take all of the medication just as your doctor instructs,
even if your symptoms are gone before the medicine runs out.
Chronic Sinusitis
If your doctor thinks you have chronic sinusitis,
intensive antibiotic therapy may be prescribed. Surgery is
sometimes necessary to remove physical obstructions that may
contribute to sinusitis.
Sinus Surgery
Surgery should be considered only if medical
treatment fails or if there is a nasal obstruction that cannot
be corrected with medications. The type of surgery is chosen
to best suit the patient and the disease. Surgery can be performed
under the upper lip, behind the eyebrow, next to the nose
or scalp, or inside the nose itself.
Functional endoscopic sinus surgery (FESS)
is recommended for certain types of sinus disease. With the
endoscope, the surgeon can look directly into the nose, while
at the same time, removing diseased tissue and polyps and
clearing the narrow channels between the sinuses.
The decision whether to use local or general
anesthesia will be made between you and your doctor, depending
on your individual circumstances.
Before surgery, be sure that you have realistic
expectations for the results, recovery, and postoperative
care. Good results require not only good surgical techniques,
but a cooperative effort between the patient and physician
throughout the healing process. It is equally important for
patients to follow pre- and postoperative instructions.
Nonmedical treatments, such as drinking plenty of water, can
thin mucus and promote drainage. Inhaling steam during a shower
or from a basin of boiled water provides some relief. Covering
the head and basin with a towel maximizes the effect.
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