Medical Treatment of Recurrent Sinusitis

Clinical History:

Pt presented with a history of sinus congestion, pressure and increased post nasal drip over the course of 2 months.  The patient’s history is relevant for recurring bouts of sinus infections that require treatment with medications, specifically antibiotics and steroids.  In fact, this individual underwent sinus surgery years prior due to the recurrent nature of sinus infections.  During this office visit, the patient has not had any relief with 7 day courses of antibiotic therapy and seeks further care at GNO Snoring and Sinus.  In addition to symptoms of sinus pressure, nasal congestion, and post nasal drip, the patient also relates increased ear pressure.

Physical Exam:

Clinical and physical exam revealed a component of pressure and discomfort overlying both maxillary(cheek) and forehead(frontal) sinuses.  Nasal exam revealed significant congestion and redness(erythema), consistent with inflammation.   An in-office CT Sinus was then performed revealing diffuse sinusitis at all sinus cavities(Pre Treatment).   This resulted in an accurate diagnosis of bilateral recurrent acute sinusitis as the cause of this patient’s symptoms. 

Treatment: The patient was placed on a 21 day course of antibiotic therapy and a brief regimen of steroids.

Before:

PreTreatment CT Scan: (3/9/2016)

CR-Before

After:

Treatment: Prolonged course of antibiotics and steroids – (3/9/2016)
PostTreatment CT Scan:  (3/30/2016)

CR-After

Summary: Following appropriate medical treatment with a prolonged course of antibiotics and steroids, the patient noted a significant decrease in the symptoms of congestion, sinus pressure, and post nasal drip.  The ear pressure had resolved as well.  This is evident from the improved sinus drainage noted in the PostTreatment CT Sinus.  One can even appreciate the widened surgical sites this patient had created during surgery many years prior.  Often times a patient has been treated with traditional courses(7-10 days) of antibiotic therapy without much relief, whereas a slightly longer course with a different antibiotic will be more effective at resolving both recurrent and chronic sinus problems.  Short courses of steroids are a key component of sinus treatment as well due to their anti-inflammatory effects.   Confirmation of the extent of sinus disease by CT Scan is important before starting patients on prolonged courses of antibiotics, as they are not without side effects.  With an accurate diagnosis, proper treatment is provided resulting in improved clinical symptoms.

To learn more about the various treatment options available for sinus disorders at GNO Snoring and Sinus, please contact us to learn more.