Alternativesto endoscopic sinus surgery

Before going ahead with endoscopic sinus surgery, there may be other things you can try first, depending on your condition.

Medications for sinusitis

Sinusitis is often made worse by allergies or infections. With treatment, your nasal symptoms may improve enough for you avoid surgery. Oral contraceptives and certain prescription drugs, used for treating high blood pressure and mood disorders, can also increase nasal congestion.

Decongestant nasal sprays or drops

These medications, available from your pharmacy, can rapidly reduce inflammation in your nose and sinuses. They are only for short-term use. If you use them for more than several days in a row, you may get a rebound (worsening) effect when you stop.

Nasal steroids

Steroid nasal sprays are a potential long-term treatment for chronic sinusitis but do not give immediate relief. You need to use them on a regular basis to reduce inflammation in your nose and sinuses. If you have other health conditions, you need to talk to your doctor before taking nasal steroids. Your pharmacist can recommend a steroid nasal spray.

Allergy medications

If your nasal symptoms have an allergic component, you may benefit from an antihistamine, which are available as tablets and nasal sprays. If you’re choosing a tablet, look for one that doesn’t cause drowsiness, as this can affect your ability to drive and work.

Painkillers

Pain relief medications such as paracetamol, ibuprofen or naproxen can relieve the pain caused by acute sinusitis.

Antibiotics for sinusitis

Chronic sinusitis is seldomly caused by infections, rather it’s a chronic inflammatory disease similar to asthma. Your doctor may recommend antibiotic treatment for acute flare-ups. Chronic sinusitis can be difficult to cure with antibiotics. Antibiotics don’t always work because many of the bacteria that can cause chronic sinusitis are resistant to commonly used antibiotics.

Ideally, you should have a test to work out which antibiotic is most likely to be effective. Some antibiotics are used because of their anti-inflammatory properties and you may need to take the antibiotic for several months.

Non-drug methods of treating sinusitis

Nasal irrigation

Rinsing out the inside of your nose with salt water can help relieve obstruction. It can also boost the effectiveness of the tiny hairs (cilia) that line the inside of your nose and help to clear mucus. Adding salt and bicarbonate of soda will feel more comfortable than plain water. Commercially available nose and sinus rinses (in squeezy bottles) can be found at any pharmacy. You can get a nasal irrigation device called a neti pot from some pharmacies. Whatever you use, it’s important to keep it clean to reduce the risk of introducing infection. Also, you must use a safe source of water. Tap water should ideally be boiled and cooled.

You can also buy saline nasal sprays at the pharmacy. They’re a good choice for children with nasal congestion.

A vaporiser or humidifier

Vaporisers and humidifiers add moisture to the air you’re breathing and can ease sinus symptoms, especially if you have an infection.

Vaporisers heat water to make steam so they can be a hazard around children, unlike humidifiers which produce a cool mist. If you’re using a vaporiser or humidifier, make sure your room has a chance to dry out regularly as the damp air can harbour bacteria, mould and dust mites. You also need to clean your vaporiser or humidifier carefully after use.

A hot shower

A hot shower creates steam which can act in a similar way to a vaporiser or humidifier and reduce sinus symptoms.

Managing allergies

Managing your allergies may help your sinus inflammation and control symptoms.

Balloon sinuplasty for sinusitis

Balloon sinuplasty is a relatively new procedure that may be used as an alternative to endoscopic sinus surgery for some people with sinus problems. 

Performed in your doctor’s rooms or a day clinic using local anaesthesia, balloon sinuplasty can open up your sinuses without the need to remove any bone or tissue. Your doctor inserts a nasal endoscope followed by a balloon catheter into your nose. The balloon is expanded to widen the sinus opening, then deflated and removed.

Very few surgeons perform this procedure as it’s not seen as effective and isn’t recommended.