Modern Medicine, Herbal Support, and Surgery in Sinusitis Treatment: A Holistic Approach to Acute and Chronic Sinusitis

Written by: Prof. Dr. Gediz Murat Serin – ENT and Sinus Surgery Specialist

Sinusitis, which occurs due to inflammation of the mucosal layer lining the bony cavities around the nose, is a common health issue that can significantly affect quality of life. Prolonged nasal congestion, facial pain, postnasal drip, and headaches can make a person feel physically and mentally exhausted.

So, how is sinusitis treated? How effective are herbal remedies alongside modern medical treatment options? And is surgery truly a last resort?

In this article, we take a holistic look at both acute and chronic sinusitis, exploring commonly asked questions and clarifying when modern medicine, herbal support, and surgery are utilized.

What is Sinusitis?

The sinuses are air-filled cavities in the skull that produce mucus. Normally, this mucus drains out through the nose. However, when the sinus passages become blocked, mucus can accumulate and become inflamed. Based on this, sinusitis is classified as acute or chronic.

Acute Sinusitis

• Usually begins with viral infections such as the flu or common cold, may be accompanied by allergies, and can progress to bacterial infection.
• Lasts less than 4 weeks.

Is Antibiotic Necessary for Every Case of Acute Sinusitis?

No. Most acute sinusitis cases are viral in origin and resolve on their own.

Antibiotics are not needed in the following situations:

• Symptoms last less than 10 days,
• No fever,
• Mild facial pain and improving symptoms.

In these cases, saline nasal irrigation, short-term use of decongestant sprays, and pain relievers are usually sufficient.

Antibiotics should only be considered in the following situations:

• Symptoms persist for more than 10 days,
• Symptoms are severe,
• There is a sudden worsening after initial improvement.

Unnecessary use of antibiotics can lead to resistance and side effects.

Chronic Sinusitis

• A type of sinusitis lasting more than 12 weeks.
• Often recurrent.
• May result from structural issues like allergies, nasal polyps, or septal deviation.
• Can be resistant to medical treatment.

Treatment of Acute and Chronic Sinusitis in Modern Medicine

Treatments Used in Acute Sinusitis:

• Nasal irrigation: Cleaning the nose with saline reduces inflammation.
• Decongestant spray: Recommended for short-term use of 3–5 days.
• Pain/fever relievers: Used for headache and facial pain.
• Antibiotics: Given only if bacterial infection is suspected.

Treatments Used in Chronic Sinusitis:

• Corticosteroid sprays: Reduce inflammation inside the nose.
• Allergy treatment: Treat if allergic rhinitis is present.
• Long-term antibiotics: Especially for bacteria forming biofilms.
• Immune support: If an immune deficiency is detected.

Herbal Supports and Complementary Medicine

Due to prolonged symptoms, chronic sinusitis patients may seek herbal and alternative treatments. However, it is extremely important to use these supports under medical supervision.

Herbal Supports with Proven Scientific Effect:

• Eucalyptus oil: Used in steam inhalation as a natural decongestant.
• Ginger and turmeric: Have anti-inflammatory properties.
• Garlic: Possesses antibacterial effects.
• Peppermint oil: May reduce congestion due to menthol content.
• Propolis and honey: Act like natural antibiotics.

Warnings:

• Herbal products may interact with medications.
• They carry allergy risks (especially propolis, peppermint oil).
• In children, age-appropriate forms must be used.
• “Natural” does not mean harmless; dosage is important.

Reminder:

There are limited studies supporting the effectiveness of herbal products. Therefore, using these supports without consulting your doctor may reduce the effectiveness of current treatments or lead to adverse effects.

When Is Surgery Necessary?

Surgery becomes an option in chronic sinusitis cases that do not respond to medical treatments for more than 3 months or if structural issues exist inside the nose.

Endoscopic Sinus Surgery (ESS)

• The sinuses are accessed through the nose using a camera, and the passages are opened.
• Natural drainage is restored without external incisions.
• Patients are usually discharged the same day or the following day.

Navigation-Assisted Surgery

• Used especially in complex cases or revision surgeries.
• Matching CT data with the system reduces the risk of error.

Balloon Sinuplasty

• Balloons are inserted into the sinus passages and inflated to open blockages.
• Particularly effective in narrow, hard-to-reach frontal sinuses.
• Works without damaging tissue, resulting in faster recovery.

Can Sinusitis Recur After Surgery?

• If underlying causes (allergy, polyps, deviation, etc.) are resolved, recurrence is unlikely.
• Environmental factors such as smoking, air pollution, and allergen exposure increase the risk of recurrence.
• Regular nasal irrigation and follow-up with your doctor are crucial after surgery.

Conclusion: A Holistic and Personalized Approach is Essential

There is no single solution for sinusitis treatment.

• Acute sinusitis often resolves on its own.
• Chronic sinusitis can be more resistant and may require surgery.
• Herbal supports should be considered only as complementary.

Remember: If you have long-standing nasal congestion, postnasal drip, or headaches, consulting an ENT specialist is the most appropriate step.