Treatments

Rhinosinusitis treatments come in a wide variety of formats. Each approach suits a different level of severity, type of cause, and so forth. Here are several categories of treatments:

Pharmaceutical

Pharmaceutical remedies claim to offer intermediate relief between herbal and surgical remedies. Some are systematic (affecting the entire body), while others are local (applied directly to the nose and upper respiratory tract). Pharmaceuticals often have serious side effects, and some are only available with a prescription.

• Non-steroidal anti-inflammatories (NSAIDs)include aspirin, ibuprofen, naproxen, and other. These reduce inflammation throughout the entire body. These are inexpensive and widely available, although they do have side effects and as such are not ideal for extended use.
• Steroids can be applied topically. These require a few weeks to take effect, although can be taken for extended use. They work by encouraging blood flow in the affected area. Spray steroids are now available without a prescription, and do not carry the same side effects as systemic steroids that some athletes take, although still are not recommended for children.
• Oxymetazoline acts quickly, and lasts up to twelve hours. However, it is only intended for temporary relief, and extended use can causes rhinitis medicamentosa, i.e. inflammation of the nose caused by the medicine.
• Levomethamphetamine and other related compounds are variants of methamphetamine, available as nasal inhalers (along with herbal ingredients). These also aim to increase blood flow to the affected areas. However, they only last a few hours, and have side effects, making them unsuitable for extended use.
• Sodium chloride

Surgical

Surgery is generally considered a last resort. It has serious risks for the body, and is expensive, and still may not fully treat the condition.

• Functional endoscopic sinus surgery is a modern approach that has replaced its antecedents. This involves inserting a tube into the nose with a camera.
• Balloon sinuplasty

Herbal

Herbal remedies have existed since long before modern medicine, although often without significant scientific evidence. As such, these remedies tend to offer milder relief, although with fewer side effects. This makes herbal remedies an appropriate place to start experimenting, and especially suitable for milder cases of rhinosinusitis.

• Pungent herbs can provide mild relief with few side effects, and taste great.
  • Capsaicin
  • Garlic
  • Black pepper
  • Turmeric
  • Ginger

Physiological

• Valsalva maneuver is a technique that can balance the pressure in the ears and sinuses, when performed carefully.

Diagnostic

Diagnostic tests such as imaging are not treatments per se, however these can reveal underlying anatomical or physiological problems. As such, they are generally performed before surgery, and can also be conducted simply to gain a better understanding.

• Computed Tomography (CT) scan combines numerous X-ray images to produce a 3D map. The X-rays contribute enough radiation to cause health concerns in extreme cases, however are generally tolerated. Because this is a more common and affordable imaging modality, it is one of the first approaches.
• Positron Emission Tomography (PET) scan is a more advanced form of imagery that costs more yet produces fewer harmful effects.