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Treating sinusitis

Around two thirds of people who get sinusitis don’t need to see their GP. Most cases are caused by a viral infection that often clears up on its own.
Sinusitis takes about two-and-a-half weeks to clear, which means it lasts longer than a cold.
For mild sinusitis, over-the-counter painkillers such as paracetamol and ibuprofen can be used to relieve a headache, high temperature and facial pain or tenderness.
Children under 16 years of age shouldn’t take aspirin, and ibuprofen isn’t recommended for people with certain health conditions, including asthma, stomach ulcers and severe heart failure.
Decongestant medication such as nasal sprays or drops may help relieve your symptoms. They’re available over-the-counter from pharmacies and can help unblock your nose, allowing you to breathe more easily.
However, decongestants won’t help speed up your recovery from sinusitis and shouldn’t be used for more than a week at a time.
When to see your GP
See your GP if your symptoms don’t improve after seven days, if they’re getting worse, or if your sinusitis keeps coming back.
If you have severe or chronic (persistent) sinusitis, your treatment options will include:
steroid sprays or drops
surgery (if all other treatments have failed)
Your GP may refer you to an ear, nose and throat (ENT) specialist, who will carry out some tests to find the underlying cause of your sinusitis. Chronic sinusitis may last for several months.
Antihistamines may be recommended in cases where sinusitis is associated with an allergy.
Your GP may prescribe a course of antibiotics if your symptoms of sinusitis are severe and they haven’t improved after seven days.
About a third of people with sinusitis will develop a bacterial infection that requires antibiotic treatment.
Steroid drops or sprays
Steroid drops or sprays are usually prescribed if you’re diagnosed with chronic sinusitis because they can help reduce your swollen sinuses.
If your symptoms don’t improve after a course of antibiotics, and you’re still experiencing problems with your affected sinuses, functional endoscopic sinus surgery (FESS) may be recommended.
FESS is the most common operation for sinusitis and it can be effective in relieving the symptoms.
The procedure is usually carried out under general anaesthetic, but it can also be performed under local anaesthetic (where your nose is numbed).
During the procedure, the surgeon will insert an endoscope into your nose. This is a thin tube with a lens at one end that magnifies the inside of your nose. This will allow the surgeon to see the opening of your sinus drainage channels.
The surgeon will then either:
remove any tissues, such as nasal polyps (growths) that are blocking the affected sinus
inflate a tiny balloon inside your nose to open up the drainage passages from your sinuses (this is known as a balloon catheter dilation)
The operation will improve the drainage of your sinus and help your sinus to function properly.
The surgeon may also insert a self-dissolving implant into your sinus, which expands to hold the sinus open and deliver a steroid called mometasone directly to the sinus lining.

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