Sinusitis: Therapy

General measures

  • Inhalation of chamomile
  • If necessary, bed rest; raise head end of bed so head is elevated (reduces sinus pain)
  • Observance of the general hygiene measures!
  • Nicotine restriction (refrain from tobacco use).
  • Alcohol restriction (abstaining from alcohol)
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of environmental stress:
    • Intoxications* (poisonings) can possibly increase the risk
    • Avoid intense heat or cold, as temperature changes increase sinus pain.

* Without specifying the type of intoxication.

Conventional non-surgical therapeutic methods

  • Nasal irrigation-daily nasal irrigation with hypertonic saline improves quality of life with respect to sinusitis symptoms, reduces sinus discomfort and medication use in patients with chronic or recurrent (recurrent) sinusitis/rhinosinusitis (simultaneous inflammation of the nasal mucosa (“rhinitis”) and the mucosa of the paranasal sinuses). In a randomized controlled trial of 871 adult patients with chronic or recurrent rhinosinusitis, nasal rinses were effective; they significantly changed the RSDI score (Rhinosinusitis Disability Index score). Note: do not use in the acute phase.
  • So-called decongestant high inserts (at the ENT doctor); the ventilation of the sinuses leads in most cases to a cure; often then no antibiotic therapy is required.
  • Radio-Tympano-Sinu Orthosis (RTSO): nuclear medicine procedure for the treatment of chronic sinusitis that does not respond to medication or surgery. In this procedure, one to two drops of a radioactive substance are applied as a fine spray to the inflamed mucosa. Suitable radioactive particles include erbium or rhenium. The RTSO lasts ten minutes. After a few days, no radioactivity is detectable.

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grain products).
  • Observance of the following special dietary recommendations:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Physical therapy (including physiotherapy)

  • Nasal irrigation (see above).
  • Heat therapy: steam inhalation:
    • For symptom relief
    • If possible 38-42 °C

    In a randomized controlled trial of 871 adult patients with chronic or recurrent (recurrent) rhinosinusitis (simultaneous inflammation of the nasal mucosa (“rhinitis”) and inflammation of the mucosa of the paranasal sinuses), inhalation of water vapor was ineffective; it did not change the RSDI score (Rhinosinusitis Disability Index score).In acute rhinosinusitis (ARS), a positive effect is suspected.