The nasal sinuses are actually hollow cavities that occur within the facial bones. Infection that occurs within these cavities is called sinusitis. If abrupt in onset, it is referred to as acute sinusitis. If present for months or years, it is referred to as chronic sinusitis. Acute sinusitis is characterized by fever, facial pain, and greenish nasal discharge. Chronic sinusitis may take the form of only year-round nasal congestion, post nasal drainage, or chronic cough. Chronic sinusitis is also a well recognized factor in poorly controlled asthma. A sinus infection is considered an abscess, that is, a localized collection of pus within a confined space. In chronic sinusitis, the pus is markedly thickened and more resistant to short-term treatment with antibiotics.
It is a general rule that to adequately treat chronic sinusitis, like any abscess, appropriate therapy includes antibiotics and effective drainage. Drainage requires maximizing the patency of the natural opening of the sinuses that lead into the nasal cavity itself. Unfortunately, the infective process leads to decreased drainage by causing tissue swelling around these openings, thereby reducing normal drainage. In fact, this is probably why the sinus infection persists so long in many cases. Without adequate medical therapy to optimize drainage, surgical intervention will probably be required. Granted, the below listed regimen is initially time consuming, but if followed carefully, will cure most cases of chronic sinusitis.
 |
Inhaled Steroids: The purpose of this medication is to reduce the inflammation within the nasal cavity that contributes to the swelling of the natural openings of the sinuses, as mentioned above. These steroids do not cause any long-term damage to nasal tissue but, in fact, actually enhance the body's ability to reduce infection. |
|
Nasal Saline: This aids in washing out mucous that plugs the sinus openings. It also washes away inflammatory products that can itself reduce inflammation. Use at least 3 - 4 sprays in each nostril 3 - 4 times a day or as many times as tolerated (you cannot overuse saline). You may make your own salt solution by mixing one teaspoon of salt with one quart of water. Store the mixture in the refrigerator and on a daily basis, pour a fresh sample into an empty nasal spray bottle. Be careful to clean the spray bottle by washing with warm soap water and rinsing well. Make sure that you let the solution warm to room temperature before you use it as it may be painful when used cold. The only time salt water is not recommended is within an hour before or after using medicated nasal sprays. Ensuring your home is adequately humidified is also essential. |
|
Antihistamines / Decongestants: These reduce inflammation and mucous production. In some cases, excessive nasal drying can occur with use of these medications. |
|
Antibiotics: These are usually prescribed for 3 - 4 weeks, and this may need to be repeated. Remember, even the best antibiotic will, when used without the inhaled steroids, lessens the likelihood of cure. |
Final note: Although major improvement may be noted within days or weeks, chronic sinusitis is rarely cured that early, and will recur if this regimen is discontinued to soon. The minimum time that all the above therapies should be used together is 3 - 4 weeks, regardless of how soon improvement appears to occur.
Salt Water Lavage
1 tsp of salt
1 qt of water
Keep refridgerated. On a daily basis pour a fresh sample of salt water into an empty nasal pray bottle. Let warm to room temperature prior to using. You cannot overuse salt water.
It is recommended to use 5 - 6 sprays in each nostril 10 times daily if tolerated. The minimum dosage should be 5 - 6 sprays in each nostril 3 - 4 times daily.
The only time salt water is not recommended is directly after using medicated nasal sprays such as Beconase AQ, Vancenase AQ/ Nasacort, or Nasalcrom.
Back to Allergy/Asthma Page
To email us with questions, comments, or suggestions, click