Avoid smoking, which can increase the risk of sinus trouble. Experts advise rinsing out the nose twice a day with saltwater to minimize symptoms and flare-ups of sinusitis, including after sinus surgery. Nasal irrigation involves pouring or squirting a saline solution — from a neti pot or squeeze bottle — into one nostril and letting it drip out through the other. Doing so can help thin the mucus, reduce swelling and wash out any germs, allergens or inflammatory cells or proteins from the nose. A 2007 scientific review concluded that adding saline nasal irrigation to standard therapies is likely to improve symptom control in chronic sinusitis.
After a thorough history and physical examination have been completed, there are still a few more important steps that must be taken before a final decision is made about the need for surgery. Sinus surgery, except in emergency situations, should almost never be offered to the patient unless aggressive medical treatment has been attempted in the past and has failed. Such medical therapy may include long -term antibiotic directed at the most likely sinusitis causing pathogens, oral decongestants, topical steroid preparations, and allergic desensitization therapy, if indicated. If these approaches have failed and rhinoscopic examination demonstrates an obvious anatomic derangement or pathology that could account for the patient’s symptoms, a complete coronal CT scan without contrast of the paranasal sinuses is ordered. The completed CT scan is reviewed with the patient, noting any functional deformity or disease that may explain the condition and may be amenable to surgical management.