Treatment for sinus infections: When is it time for surgery?

June 26th, 2017

When you get a sinus infection, and it doesn’t go away quickly on its own or it gets severe, you should consider seeing your doctor.  A general practitioner may prescribe medicine or recommend other treatment, or they may refer you to an Ear, Nose and Throat doctor. This type of specialist is also known as an ENT specialist, an otolaryngologist, or an otorhinolaryngologist.[1] They are experts in sinus infections and related conditions, and they often get involved in particularly persistent or severe cases.

First-line treatments: Medicine, rest, other treatments

Surgery is not the first line of defense. Other treatments should be tried first, and surgery is generally considered only if these treatments aren’t effective.[2]

Medicine: Over-the-counter and prescription medicines are often used to treat sinus infections. These include:

  • decongestants to relieve stuffy nose and related symptoms
  • antibiotics to kill bacteria that cause acute sinusitis, usually following a cold
  • corticosteroids, used as a nasal spray or taken by mouth, to reduce inflammation

Rest: The body needs to devote time and energy to supporting the immune system as it fights the infection. Getting plenty of rest is recommended for a faster recovery from sinus infections.[3]

Fluids: Drink plenty of fluids. Staying hydrated is important in general, and warm liquid such as tea can help loosen mucus. Breathing in steam, such as from a hot shower, can also help.

Rinsing: Special products exist to flush out the sinus cavities. These include nasal irrigation kits and sterile salt-water (saline) nasal sprays.

If first-line treatments don’t work

When these treatments don’t work and the sinus infection has lasted for more than a couple of months, if you have not already done so, it may be time to see an ENT.

The ENT specialist may consider surgery as the next step. This depends on the patient’s specific condition. Typically, patients will undergo a computed tomography (CT) scan of the sinuses. This device utilizes special x-ray equipment to evaluate the sinus cavities to determine if the sinuses are obstructed. Scans that show a persistent disease are possible candidates for surgery.

Modern sinus surgery is performed using small instruments that are inserted through the nostrils. With these instruments, the surgeon cuts away polyps and other abnormal or diseased tissue, so that the sinus passages can open up, mucus doesn’t collect, and infections don’t happen as easily.

In some instances, the ENT may use the PROPEL sinus stent following surgery. This device is implanted in the sinus cavity after sinus surgery. It helps prop the sinus open, delivers anti-inflammatory medicine, and dissolves slowly so it doesn’t usually need to be removed.

Whether or not you need sinus surgery is a matter to be discussed with your physician. If you have sinus symptoms that keep coming back or that stay around for many weeks, it may be an option to help you breathe freely once more.


[1] http://www.entnet.org/content/sinus-surgery

[2] http://care.american-rhinologic.org/ess

[3] http://newsnetwork.mayoclinic.org/discussion/treating-sinus-infections-without-antibiotics/

Why find an ENT physician ?

If you suffer from chronic sinus infections, you may need to see an ENT physician, who is also called an ear, nose, and throat doctor or an otolaryngologist. These specialized physicians are experts in both the medical and surgical management of chronic sinusitis.

Intersect ENT makes information about physicians and facilities that offer PROPEL® sinus stents available. Physicians and facilities are listed based upon proximity to the zip code you have entered.

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Safety Information

The purpose of the site is to help create awareness about sinusitis and treatment options for the disease. Please note that information contained on this site is not medical advice. It should not be used as a substitute for speaking with your physician. Always talk with your physician about diagnosis and treatment information.

The PROPEL sinus implants are intended for use after sinus surgery to maintain patency and to locally deliver steroids to the sinus mucosa: PROPEL for use in the ethmoid sinus, PROPEL Mini for use in the ethmoid sinus and frontal sinus opening, and PROPEL Contour for use in the frontal and maxillary sinus ostia. The implants are intended for use in patients ≥18 years of age. Contraindications include patients with intolerance to mometasone furoate (MF) or a hypersensitivity to bioabsorbable polymers. Safety and effectiveness of the implants in pregnant or nursing females have not been studied. Risks may include, but are not limited to, pain/pressure, displacement of implant, possible side effects of intranasal MF, sinusitis, epistaxis, and infection. For complete prescribing information see IFU at www.IntersectENT.com. Rx only.

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