What is the best treatment for sinusitis?

Written by Li Rui
Otolaryngology
Updated on September 21, 2024
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The treatment of sinusitis is currently divided into two main categories: conservative treatment and surgical treatment. The specific choice of treatment mainly depends on the severity and type of sinusitis. For fungal sinusitis, conservative treatment generally does not yield good results. If the patient's condition permits and their physical health can tolerate surgery, it is generally recommended to perform sinus opening surgery under endoscopy. For bacterial sinusitis with mild inflammation, unclear symptoms, or relatively mild symptoms, conservative drug treatment can be considered. This usually involves oral medications and nasal sprays, and saline nasal irrigation can also be considered. If the inflammatory response is more severe and the symptoms are typical, and conservative treatment is ineffective, sinus opening surgery should be considered. Currently, minimally invasive surgery under endoscopy is employed, which generally yields precise results, causes less damage, and allows for a quicker recovery.

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Written by Li Rui
Otolaryngology
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What are the symptoms of sinusitis?

The clinical symptoms of sinusitis vary widely among individuals, and in general, it is considered a common illness. The most frequent clinical manifestations include nasal congestion, purulent nasal discharge, reduced sense of smell, headaches, and dizziness. Some patients may also experience facial pain and numbness; however, specific symptoms vary from person to person. Some may exhibit only one symptom, while others may experience two to three, or even multiple symptoms, with the disease demonstrating recurrent and fluctuating patterns. In terms of treatment, medication remains the primary approach, supplemented by nasal irrigation. Only a small fraction of patients, whose symptoms do not improve with conservative medication treatments or who suffer from particularly severe inflammatory reactions like fungal sinusitis, may consider surgery.

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Written by Li Rui
Otolaryngology
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What is acute sinusitis?

Acute sinusitis is an acute inflammatory response of the sinuses caused by a sudden bacterial infection. Clinically, the most common sites of lesion are the maxillary sinuses and ethmoid sinuses, though some patients may also experience inflammation in the frontal sinuses or sphenoid sinuses. The main symptoms include sudden nasal congestion, purulent nasal discharge, headaches, dizziness, and reduced sense of smell. If the inflammatory response is particularly severe, it may also affect vision or cause fever and a feeling of heaviness in the head. Overall, it is considered to be an acute inflammatory response, primarily treated clinically with antibiotics to counter the infection, along with the use of nasal sprays and nasal irrigation, typically with saline solution. Regular follow-up checks are required, and the recovery period generally lasts about one to two weeks. (Medication should be used under the guidance of a doctor based on specific circumstances.)

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Written by Li Rui
Otolaryngology
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How to alleviate sinusitis?

The acute phase of sinusitis largely depends on the extent of the inflammation. If the inflammation is mild and the symptoms are atypical or slight, saline nasal irrigation can be considered. If the inflammatory reaction is severe and accompanied by clear symptoms like nasal congestion, purulent nasal discharge, headaches, and dizziness, then medical treatment should be considered. Generally, the treatment consists primarily of oral antibiotics, along with traditional Chinese medicines and mucolytics, supplemented with nasal sprays. Regular follow-ups are advised, and the treatment period usually ranges from one to two weeks. If standardized medication does not work, or in the case of fungal sinusitis, surgery may be necessary.

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Written by Zhang Jun
Otolaryngology
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Treatment of Chronic Rhinitis and Sinusitis

Chronic rhinitis and chronic sinusitis are due to persistent inflammation following acute inflammatory stimuli or recurrent attacks, leading to nasal and systemic symptoms. Patients may experience facial swelling and pain, headaches, and nasal congestion, generally bilateral and progressively worsening. Additionally, there may be yellow purulent discharge from the nasal cavity, sometimes accompanied by an odor. The examination can reveal congested and edematous bilateral nasal turbinates and abnormal secretions in the nasal cavity. For treatment, patients initially need a sinus CT scan; if sinusitis is confirmed, symptomatic anti-inflammatory treatment is necessary, including oral antibiotics, such as cephalosporins, which are relatively effective. Saline nasal irrigation is also required. If conservative treatment fails, the patient may need endoscopic sinus surgery and partial resection of the bilateral inferior turbinates to recover.

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Written by Li Rui
Otolaryngology
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Does sinusitis affect the eyes?

Sinusitis is a relatively common otorhinolaryngological disease. A small percentage of patients may experience effects on their eyes, leading to decreased vision, orbital abscesses, eye swelling and pain, or visual field defects. There is significant individual variation in clinical symptoms. After the onset of the disease, it is necessary to visit the otorhinolaryngology and ophthalmology departments to assess the severity of the condition. In terms of treatment, some patients may opt for conservative medical treatment. However, for others with more severe conditions where conservative medical treatment proves ineffective, surgical treatment should be considered, followed by regular follow-up exams to observe the outcomes of the surgery.