How should sinusitis be treated?

Written by Li Mao Cai
Otolaryngology
Updated on September 24, 2024
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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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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.)

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Otolaryngology
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How to check for sinusitis?

The examination for sinusitis is mainly divided into three major categories. The first category is visual inspection. The second is endoscopic examination, and the third is radiologic examination. Visual inspection mainly involves directly observing with the naked eye the mucosa inside the nasal cavity, the inferior turbinate, and assessing the presence of thick nasal mucus. For some patients, a basic diagnosis can be made through visual inspection alone. However, for other patients whose conditions are not very clear, it becomes necessary to use endoscopic examinations, such as nasal endoscopy or fiberoptic nasopharyngoscopy, to visually inspect the interior of the nasal cavity and the nasopharynx for any abnormalities. If the inflammation is severe and conservative medical treatment is ineffective, it may also be necessary to consider a CT scan of the sinuses to make a clearer and more accurate diagnosis.

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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 the best treatment for sinusitis?

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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Is sinusitis a serious illness?

Sinusitis is a common and frequently occurring disease in otolaryngology. Patients with sinusitis mainly suffer from blockages at the sinus openings due to polyps, tumors, and mucosal edema, which leads to pus and fluid accumulation within the sinuses. The primary symptoms in patients include nasal congestion, runny nose, headaches, and fever. For patients with sinusitis, the first step should be to use a paranasal sinus CT scan to make a definitive diagnosis of the disease and identify the affected sinus locations. Treatment can then involve the use of decongestants and corticosteroid medications to address symptoms. For sinusitis caused by foreign bodies or nasal polyps and tumors, surgical opening of the sinus openings can be performed to restore normal sinus drainage and cure the disease. (Specific medications should be used under the guidance of a doctor.)