Before going ahead with endoscopic sinus surgery, there may be other things you can try first, depending on your condition.
Medications for sinusitis
Sinusitis is often made worse by allergies or infections. With treatment, your nasal symptoms may improve enough for you avoid surgery. Oral contraceptives and certain prescription drugs used for treating high blood pressure and mood disorders can also increase nasal congestion.
Decongestant nasal sprays or drops
These medications, available from your pharmacy, can rapidly reduce inflammation in your nose and sinuses. They are only for short-term use. If you use them for more than several days in a row, you may get a rebound (worsening) effect when you stop.
Steroid nasal sprays are a potential long-term treatment for chronic sinusitis, but do not give immediate relief. You need to use them on a regular basis to reduce inflammation in your nose and sinuses. If you have other health conditions, you need to talk to your doctor before taking nasal steroids. Your pharmacist can recommend a steroid nasal spray.
If your nasal symptoms have an allergic component, you may benefit from an antihistamine, which are available as tablets and nasal sprays. If you’re choosing a tablet, look for one that doesn’t cause drowsiness, as this can affect your ability to drive and work.
Antibiotics for sinusitis
Chronic sinusitis may be caused by infection but not always. Your doctor may recommend antibiotic treatment. Chronic sinusitis can be difficult to cure with antibiotics. Antibiotics don’t always work because many of the bacteria that can cause chronic sinusitis are resistant to commonly used antibiotics.
It can also be difficult to get the antibiotic to penetrate to the site of the infection, which can be inside the bones of your sinuses. Ideally, you should have a test to work out which antibiotic is most likely to be effective. You may need to take the antibiotic for several months.
Non-drug methods of treating sinusitis
These are small adhesive-backed strips that you stick over your nose. They contain spring-like bands that help lift the sides of your nose away from the septum, immediately opening your nasal passages. People often use nasal strips at night, especially if a blocked nose is causing snoring. Nasal strips are available from pharmacies.
Rinsing out the inside of your nose with salt water can help relieve obstruction. It can also boost the effectiveness of the tiny hairs (cilia) that line the inside of your nose and help to clear mucus. Adding salt and bicarbonate of soda will feel more comfortable than plain water. Commercially available nose and sinus rinses (in squeezy bottles) can be found at any pharmacy. You can get a nasal irrigation device called a neti pot from some pharmacies. Whatever you use, it’s important to keep it clean to reduce the risk of introducing infection. Also, you must use a safe source of water. Tap water should ideally be boiled and cooled.
You can also buy saline nasal sprays at the pharmacy. They’re a good choice for children with nasal congestion.
A vaporiser or humidifier
Vaporisers and humidifiers add moisture to the air you’re breathing and can ease sinus symptoms, especially if you have an infection.
Vaporisers heat water to make steam so they can be a hazard around children, unlike humidifiers which produce a cool mist. If you’re using a vaporiser or humidifier, make sure your room has a chance to dry out regularly as the damp air can harbour bacteria, mould and dust mites. You also need to clean your vaporiser or humidifier carefully after use.
A hot shower
A hot shower creates steam that can have a similar effect to a vaporiser or humidifier, reducing sinus symptoms.
Avoiding irritants that cause nasal inflammation may help you avoid or delay surgery. Many things can cause nasal inflammation or make it worse. An allergic reaction to pollen, dust mites or animals may cause additional nasal symptoms known as allergic rhinitis, and may require treatment with antihistamines.
Irritation from smoke, paint fumes, household chemicals or perfumes is another common cause of nasal inflammation. Some people experience nasal congestion in response to certain foods and drinks such as red wine, milk or beer.
Balloon sinuplasty for sinusitis
Balloon sinuplasty is a relatively new procedure that may be used as an alternative to endoscopic sinus surgery for some people with sinus problems. It’s less invasive than other types of sinus surgery and has a shorter recovery time.
Performed in your doctor’s rooms or a day clinic using local anaesthesia, balloon sinuplasty can open up your sinuses without the need to remove any bone or tissue. Your doctor inserts a nasal endoscope followed by a balloon catheter into your nose. The balloon is expanded to widen the sinus opening, then deflated and removed.
Most people find that the discomfort with this procedure is minimal and the recovery time is 1 to 2 days. Balloon sinuplasty may be suitable for people who can’t have a general anaesthetic. As it’s a relatively new procedure, doctors are still unable to make predictions about the long-term outcomes.
Only a few Australian ear, nose and throat surgeons are trained in this procedure