Nasal Steroids
Inhaled nasal steroids are effective in reducing inflammation in the sinuses and can be used for long periods of time.  The onset of action is not as immediate as decongestants, but inhaled nasal steroids provide sustained relief. Decreasing inflammation decreases the swelling within the lining of the sinuses. Typically, nasal steroids are used routinely once or twice daily, but they can be used on an as-needed basis in some cases.

Irrigation
Because the mucus within the sinuses does not drain easily, irrigation with saline can be helpful. There are several commercial irrigation solutions that can be purchased. Alternatively, irrigation saline can be made at home.  The saline can be applied using a squeeze bottle that makes a mist. For older children and adults, nasal nebulizers are available. A Water Pic^® can be used, too.

Antibiotics
Antibiotics are required for treating an acute sinus infection. Symptoms include fever, post-nasal drip, congestion and/or sinus pain. The organisms that infect the sinuses are similar to those found in the lungs. Pseudomonas aeruginosa sinus infections are common in patients with cystic fibrosis, as well as infections from bacteria such as Staphylococcus aureus. Because the sinuses are difficult to penetrate with antibiotics and clearing infections from these tiny spaces is difficult, antibiotic treatments can take several weeks. In some cases, intravenous antibiotics may be necessary.

Sinus Surgery
Sinus surgery, which removes removes infectious material and allows the sinuses to drain, is sometimes necessary when medical treatment does not resolve sinusitis. Sinus surgery is sometimes combined with the removal of polyps, which may be interfering with breathing, causing pain, or contributing to infections. Unfortunately, nasal polyps frequently recur after removal.