How should sinusitis be treated?

Written by Zhang Jun
Otolaryngology
Updated on March 27, 2025
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Sinusitis is caused by acute inflammatory infections, mainly hemolytic streptococcus or Staphylococcus aureus. Pathogens enter the sinuses through the sinus openings due to the patient catching a cold or having a flu, leading to congestion, swelling, hyperplasia, and exudation in the sinus mucosa. Symptoms include persistent nasal congestion, discharge of yellow secretions from the nasal cavity accompanied by a foul smell, and severe cases may also experience facial swelling, pain, and headaches. In terms of treatment, during the acute phase, patients need to first undergo symptomatic anti-inflammatory treatment, taking oral antibiotics such as cephalosporins, which are very effective. Additionally, physiological saline is used for nasal and sinus irrigation. If conservative treatment is ineffective, patients may require endoscopic sinus surgery and sinus mucosa clearance for recovery. (The use of medications should be under the guidance of a professional doctor.)

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Written by Deng Bang Yu
Otolaryngology
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Is sinusitis the same as rhinitis?

There are differences between rhinitis and sinusitis. Rhinitis is mainly the inflammation of the nasal mucosa, while sinusitis is the inflammation of the sinus cavity mucosa. The main clinical symptoms of rhinitis are nasal congestion and a runny nose. This runny nose is mostly mucous or watery, which is typically seen in allergic rhinitis. The runny nose in sinusitis, on the other hand, is often a thick yellow discharge caused by a bacterial infection, so there is a distinction between the two. Patients with sinusitis often have rhinitis, but those with rhinitis do not necessarily have sinusitis. Rhinitis is primarily treated with medications and rarely with surgery. For sinusitis, treatment also begins with medications; however, if the response to medical therapy is poor or the condition is severe, surgery is often considered. The likelihood of undergoing surgical intervention is generally higher for sinusitis than for rhinitis.

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Written by Li Mao Cai
Otolaryngology
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Symptoms of recurrent sinusitis

The symptoms of recurrent sinusitis are essentially the same as those of sinusitis itself. Symptoms can be divided into local symptoms, which are those of the nasal cavity, as well as some systemic symptoms, because the recurrence of sinusitis often follows a cold that leads to an acute recurrence. The nasal symptoms mainly include nasal discharge, primarily consisting of yellow pus-like mucus. There may also be nasal congestion or a sensation of the nose being blocked, as well as headaches. The location and severity of the headache depend on which sinus is more severely inflamed, which also affects where the headache is felt. Additionally, there may be a disturbance in the sense of smell, which refers to a reduced sensitivity to smells, or a reduced ability to smell or weak sense of smell. Systemic symptoms mainly include lethargy, feelings of headache and weakness, lack of concentration, and a general lack of energy. Overall, the symptoms of recurrent sinusitis are similar to those of initial sinusitis, with most being the same.

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Written by Li Mao Cai
Otolaryngology
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How should sinusitis be treated?

The treatment of sinusitis should be based on the specific conditions of each patient, and different treatment plans can generally be divided into two categories. The first is conservative treatment. Conservative treatment mainly includes medication and some local nasal irrigation or puncture methods. This type of conservative treatment generally has good effects, and can relieve the pain and alleviate the symptoms of most patients with sinusitis. Apart from conservative treatment, The second method is surgical treatment. Surgical treatment now involves the reconstruction of nasal and sinus function under endoscopy. This type of surgical treatment can also be considered a minimally invasive and precise treatment plan. However, despite being minimally invasive and precise, it is still a surgery and does involve some trauma. Therefore, surgical treatment is only considered when conservative treatment is ineffective. Surgical treatment is just the beginning of a systematic approach to treating sinusitis. It can be understood this way: after the surgery, the follow-up medication treatment, which is a set of conservative treatment plans, and regular check-ups need to be promptly followed up. Reliance solely on surgical treatment may not achieve particularly ideal long-term effects.

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Written by Li Rui
Otolaryngology
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What should be paid attention to with sinusitis?

The precautions for sinusitis mainly include the following aspects: First, it is important to determine the degree and type of sinusitis. Currently, sinusitis is primarily classified into two main types: fungal sinusitis and bacterial sinusitis. It is recommended to assess the severity of the inflammation. For mild inflammation, conservative treatment is generally considered. For severe inflammation or fungal sinusitis, surgery may be necessary. Second, it is important to take precautions in daily life to avoid exacerbating sinusitis, especially by avoiding colds and opting for a lighter diet. Third, monitor the recovery of sinusitis in daily life and check for any possible complications. Therefore, it is necessary to visit an otolaryngology (ENT) clinic regularly for follow-up.

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Written by Deng Bang Yu
Otolaryngology
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How to relieve headache from sinusitis?

Sinusitis is currently the general term for what was traditionally called accessory sinusitis. Accessory sinusitis can cause headaches, which is a clinical manifestation of sinusitis. The clinical treatment of headaches primarily targets the sinusitis itself. The causes of the headaches are twofold: one is the headache caused by the irritation of purulent secretions, and the other is the negative pressure headache caused by blockage of the sinus opening and the resultant intrasinus pressure. The treatment includes using medications that constrict the blood vessels in the mucous membranes and then clearing the sinus openings. Additionally, it is crucial to actively pursue anti-inflammatory and anti-infection treatments, primarily using macrolide antibiotics or cephalosporin antibiotics. (Medication should be used under the guidance of a doctor.)