*1.10.8 Endoscopic sinus surgery*

*Sino-Nasal and Olfactory System Disorders*

Treatment for sinusitis include, nasal wash, decongestants, humidification,

Topical as well as systemic nasal decongestants can be used such as pseudoephedrine. Caution should be taken in using decongestants. Oxymetazoline should not be used for more than 3 days as it causes rebound congestion. Oral deconges-

Nasal corticosteroids help in reduction and treatment of inflammation. Nasal corticosteroid sprays include beclomethasone, fluticasone, budesonide, mometasone, and triamcinolone. Topical nasal sprays effectively treat mucosal edema but

These corticosteroids are used in severe inflammation especially if patient is suffering from nasal polyps. Oral corticosteroids have serious side effects when used

Antibiotics are given in case of bacterial sinusitis. In case of bacterial infection amoxicillin or amoxicillin-clavulanate for 10–14 days is the first line treatment. Trimethoprim-sulfamethoxazole is effective for some population but there is high rate of resistance. If symptoms do not resolve in 7 days then broader spectrum agents are used such as augmentin, axetil, cefuroxime, second or third generation cephalosporins, fluoroquinolones and clindamycin. For anaerobic bacterial infec-

If patient is sensitize to the aspirin and may develop sinusitis then under medical supervision gradually larger doses are given to patient to increase the tolerance of

Patients who are sensitive to allergens and these allergens may contribute to sinusitis. Immunotherapy is suggested to those individuals. Which help to reduce

Saline nasal wash are in the form of nasal sprays or nasal solutions, which are intended to rinse away allergens and irritants and also to reduce

tants should be used with special care in hypertensive patients [14].

for long term so, it should be used only to treat severe symptoms [16].

nasal sprays, corticosteroids, antibiotics and nasal surgery [12].

**1.10 Treatment strategies**

*1.10.1 Saline nasal wash*

*1.10.2 Nasal decongestants*

*1.10.3 Nasal corticosteroids*

*1.10.5 Antibiotics*

they are more effective in chronic sinusitis [15].

tion metronidazole can also add in the therapy [17].

*1.10.6 Aspirin desensitization treatment*

the body reaction against specific allergens.

*1.10.4 Parenteral or oral corticosteroids*

drainage [13].

**28**

aspirin.

*1.10.7 Immunotherapy*

If the medications are not effective in treatment of sinusitis then endoscopic sinus surgery would be an option. In this surgery endoscope is used to explore sinuses. Depending upon the obstruction source different instruments might be used to remove mucous or to scrap polyps [18].
