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Treatment Options for Chronic Sinusitis & Deviated Septum

Chronic sinusitis is a condition characterized by long-term inflammation of the cavities around the nasal passages, or sinuses. The syndrome is also known as chronic rhinosinusitis. In some individuals, sinusitis is caused by displacement of the thin wall (septum) that separates the right and left nostril. This condition is commonly known as a deviated septum.

  1. Understanding Deviated Septum and Chronic Sinusitis

    • According to the Mayo Clinic, roughly 80 percent of people have some displacement of their septum. While some septum deviations exist from birth, most cases are caused by some form of injury. If you have a slightly deviated septum, you may not notice it, or experience only minor changes in the normal airflow in your nostrils. However, if your deviation is severe, you may experience symptoms including nasal congestion, nosebleeds, breathing difficulties and sinusitis. Symptoms of sinusitis include pain, facial tenderness, thick nasal discharge that may be yellow or green, congestion and reductions in your senses of smell and taste. If you have these symptoms for more than eight continuous weeks, or experience repeated bouts of sinusitis, your condition is typically diagnosed as chronic.

    Nonsurgical Treatments

    • Ultimate relief of sinusitis caused by a deviated septum may require surgical repair of your septum. However, you and your doctor may first try to control your symptoms through nonsurgical means. Your doctor may begin treatment with a saline spray designed to rinse your sinuses. Additionally, he may prescribe use of a nasal corticosteroid spray to control your sinus inflammation. Potential options include triamcinolone (Nasacort AQ), fluticasone (Flonase) and budesonide (Rhinocort Aqua). If your symptoms are severe, or if you also have nasal polyps (growths), your doctor may also treat you with oral or injectable corticosteroids.

      For short-term relief of your symptoms, your doctor may recommend use of an over-the-counter oral decongestant such as Sudafed or Actifed. He may also recommend decongestant nasal sprays such as Afrin (oxymetazoline). To control pain related to chronic sinusitis, he may recommend the use of over-the-counter pain relievers such as ibuprofen (Motrin, Advil), aspirin or acetaminophen (Tylenol). If your child suffers from sinusitis, do not use aspirin under any circumstances. Consult your doctor for a full explanation of the risks and benefits of any medication he may prescribe or recommend.

    Surgery

    • If surgery is needed to repair your deviated septum, you will undergo a procedure called a septoplasty. During a septoplasty, your surgeon will place your septum in a neutral position that equally divides your nostrils. Depending on your septum's current state, repositioning may require cutting or trimming to provide a proper fit. In some cases, your septoplasty may be combined with a plastic surgery procedure called rhinoplasty to reshape your nose's bone and cartilage. Typically, the success of your septoplasty depends on the severity of your deviated septum. Consult your doctor or surgeon for more details on septoplasty for chronic sinusitis.

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