Treatment
We generally start treating sinus and allergy issues beginning with the least invasive or disruptive option, and progressing to most invasive (or surgery) if necessary. Because these are not typically life-threatening issues, we really don't "have to" do anything. We prefer to educate patients and allow them to decide how far to go with therapy. We certainly do not want to make the treatment worse than the disease.
- Plan A includes the medical therapy options described in the links below. This always includes nasal saline irrigations and usually includes a topical nasal steroid spray.
- Plan B is comprehensive allergy testing and treatment.
- Plan C is surgery. We are the most qualified surgeons in the region and offer state-of-the-art sinus surgery, and nasal surgery when necessary.
Nasal Washes/Rinses
Rinsing nasal passages with saline solutions is very effective in removing irritants.
Medications
Options considered for treating allergy and sinus problems include over-the-counter and prescription medications.
Immunotherapy for Allergies
Immunotherapy is the only allergy treatment that has the potential to cure the disease. It gets at the cause of the problem, rather than to just treat the symptoms. Most physicians agree that immunotherapy is underutilized and we are really seeing that with the new asthma guidelines as well as in treatment recommendations for eosinophilic esophagitis.
Interestingly, Immunotherapy involves the administration of the substances that trigger allergies to the patient on a regular basis. Although it seems counterintuitive, it seems to correct the immune system's hyper-responsiveness. Currently immunotherapy can be administered as subcutaneous shots or as an under the tongue tablet or drops.
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| Allergy Shots | Allergy Drops |
| Method of Administration | Shot in the Arm(s) | A Drop Under the Tongue |
| Insurance Coverage | Yes | NO |
| Risk of Anaphylaxis | Small | None Reported |
| Adverse Reactions | Multiple (Swelling, Itching, Hay fever, etc.) | Nausea, Itching/Swelling/Tingling in the Mouth |
| Physician Visit Required? | Weekly for Years | Every 6-12 Months |
| Allergy Testing Required | Yes (every 1-3 years depending on the allergy profile) | Yes (every 1-3 years depending on the allergy profile) |
| Insurance Coverage for Allergy Testing | Yes for Most Insurances | Yes for Most Insurances |
| Contraindications? | Yes (beta-blockers, history of anaphylaxis, young children, infants; severe asthmatics) | NO |
| Duration of Treatment | 3-5+ years | 3-5+ years |
| Treatment Frequency | Every 1 to 4 weeks | Once/Daily |
| Treatment Location | Physician Office on Build-Up; Home on Maintenance if not asthmatic. | Home |
| FDA Approved? | Yes | Off-Label (Currently Pending) |
| Effective? | Yes | Yes |
| Cost | Per Insurance Carrier | $100 for 2 month supply (less than $12 a week) |
Other Measures
Many other methods for treating sinus problems have been suggested.
Surgery
Nasal and sinus surgery usually serves to accomplish up to three goals