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Diagnosis and Treatment for Chronic Sinusitis

Before starting treatment, your doctor will take a complete medical history and perform a physical examination. Acute sinusitis is usually treated with antibiotics and decongestants. Chronic sinusitis may need long-term treatment (eight weeks or longer), for maximum effectiveness.

Medical treatment options include antibiotics, decongestants, Medicines that thin the mucus, nasal steroid sprays, and oral steroids. Some antihistamines have side effects, and only patients with documented allergies should use them.

Discuss over-the-counter anti-histamines with your physician; the side effects may be greater than the benefits. If treatment does not cure your sinusitis, or it recurs, a CAT scan may be necessary to evaluate the sinuses and the drainage channels in the nose that are not visible on a routine examination. Small telescopes (endoscopes) may also be used to look directly inside the nose.

Sinus Surgery: Surgery should be considered only if medical treatment fails or if there is a nasal obstruction that cannot be corrected with medications. When surgery is needed, the ENT specialist can choose from a number of different options, depending on the severity of sinus disease and the type of sinus surgery best suited to the patient.

Surgery can be performed under the upper lip, behind the eyebrow, next to the nose or scalp, or inside the nose itself. Another type of surgery is called functional endoscopic sinus surgery (FESS). It is used for certain types of sinus disease.

With the endoscope, the surgeon can look directly into the nose, while at the same time, remove diseased tissue and polyps, and clear 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.

Getting Ready for Surgery: Before surgery, be sure you understand all the possible risks and benefits of the procedure and you are aware of realistic results, recovery time, and post-operative care. Good results require not only good surgical techniques, but the cooperation of the patient throughout the healing process. It is especially important for patients to follow pre and post-operative directions.

After the Operation: Following surgery, endoscopes may be used to monitor healing, to keep the nose clean, and to prevent recurring obstructions. Sometimes the results are not immediate. It may take 12 weeks or longer before the sinus cavity heals. Patients with chronic sinus problems who are hypersensitive to air pollution or with allergies may require on-going medical care.

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