Treatments for Sinus

Sinus Treatment Options

Saline (salt water) nasal sprays

• Saline sprays are available “over the counter” at most pharmacies
• These solutions contain salt water and a preservative – they sometimes sting but most patients find that it helps nasal symptoms improve considerably
• Keeping the nasal passages clear by using saline nasal spray helps dramatically with most nasal symptoms
• Saline nasal sprays provide moisture to the nasal cavity especially during the winter months – when the environment is cold and dry outside, and hot and dry inside
• When dryness occurs mild nasal crusting may develop and bacterial infections may occur under these crusts
• Saline nasal sprays may be used to cleanse the nose and sinuses of crusts thereby promoting the natural cleaning system of the nasal passages
• Saline nasal sprays are a great option for anyone who has sinus congestion and wants to clear their sinuses
• These sprays are easy to use and effective and  can be used to moisten the nasal passages or to irrigate the sinuses
• Saline nasal sprays are also good for children and infants
• Use FESS / Sterimar / NasaMist etc. as frequently as needed to keep the nasal passages clear

Saline nasal irrigations

• The same principles for saline sprays apply to saline irrigations
• Irrigations are used when greater volumes of salt water are needed – for example when large crusts accumulate or nasal polyps cause obstruction to effective mucus clearance
• An irrigation bottle or bulb syringe with 100 to 200mL of solution may be used in each nasal cavity 2 to 3 times each day or as often as prescribed
• It is recommended that you prepare fresh solution each day and clean the bottle as needed
• The standard mixture contains 1/2 teaspoon of table salt per 250 mL of warm water – adding an equal amount of baking soda will make the solution more pH balanced
• Nasal saline irrigations are designed to relieve congestion caused from:
  • Sinusitus
  • Chronic Rhinosinusitis
  • Hay fever and Allergies
  • CPAP Therapy
  • Also ideal for clearing the nasal passages after surgery
• Good results depend on regular flushing of the nose and sinuses
•  Use twice daily or more frequently as directed

Nasal steroid sprays

• Nasal steroid sprays are very effective and are relatively easy to use – providing focused treatment to address inflammation and allergic problems of the nose – as opposed to tablets which affect the whole body
• While many people are concerned about the effects of steroids taken by mouth or injection, the side effects can be virtually eliminated with regional applications of very small amounts of steroid sprays
• The only side effect that occasionally develops is nasal dryness – which can be prevented by using saline sprays on a regular basis
• Nasal steroid sprays may be used on a long-term basis for patients with hay fever and year round allergies, polyps or inflammation of the nasal cavity
• If possible, it is recommended to stop the steroid spray for one month every three to four months to allow any dryness to resolve
• This one month “holiday” is best done during times of minimal allergy problems – Antihistamines may be helpful during this time
• As steroid sprays do not have an immediate onset of action, you should start taking them one to two weeks before the usual allergy season.

Nasal spray steroid

• Application procedures are especially important for nasal steroid sprays – it is important to aim the direction of the spray away from the nasal septum – which is the midline wall that divides the nasal passages
• If the spray continuously hits the septum it will become dry and crusted
• Ideally the tip of the bottle should go into the nose and aim slightly towards the corner of the eye, rather than go onto the septum

Uses for nasal steroid sprays include:

• To treat the nasal symptoms of seasonal and year-round allergic rhinitis (inflammation of the lining of the nose) in adults and children
• To treat nasal congestion that happens with seasonal allergic rhinitis in adults and children
• To prevent nasal symptoms of seasonal allergic rhinitis
• To treat nasal polyps
• Use Rhinocort / Beconase / Nasonex / Flixonase
  • One spray per nostril each morning as directed
  • You may benefit from using saline nasal spray to irrigate the nose

Nasal decongestant spray

• Nasal sprays such as Otrivin or Drixine are used to shrink the mucus membranes and open the nasal passages
• Nasal decongestant sprays are best used on a very limited basis – they are used most often for short-term nasal congestion as experienced with the “common cold”, flu or sinusitis
• Rarely decongestants may be prescribed for other very specific reasons
• It is important to follow the instructions carefully and use these sprays on a very limited basis
• A tolerance and dependency to these sprays can develop quickly – and patients have then found discontinuing these sprays difficult
  • These sprays are best used for a maximum of 3 to 5 days only and then discontinued
  • Use Otrivin or Drixine as directed

Other nasal medications

• Nasalate or Vaseline once or twice a day are useful to treat dryness or crusting

Also remember prevention is important

• Avoid smoke or other irritants to the nose
• Avoid environmental allergens