sinusct_mediumWe 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 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.


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.

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.


Nasal and sinus surgery usually serves to accomplish up to three goals

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