Adjuncts to medical management of sinusitis.

The basic principles of sinusitis therapy are to treat any infection present, facilitate drainage, and promote drainage both during and after treatment to prevent recurrence. Adjunctive measures promoting ciliary function and drainage through the sinus ostia include the following nonpharmacologic measures: steam, astringents, inhalations, saline, and hot, dry air. Pharmacologic measures include decongestants, topical corticosteroids for chronic sinusitis, mucoevacuants, and analgesics. Antihistamines are indicated for acute sinusitis only when a patient with concomitant allergies is symptomatic during the allergy season or after infection has been ruled out as the primary cause of sinusitis. Sinusitis may be associated with asthma, and some patients do not respond optimally to asthma therapy until their sinusitis is diagnosed and treated.