Shots and Vaccines
Getting an annual flu shot and getting the pneumococcal vaccine are always a good idea. Prevnar is a 7-valent vaccine, whereas Pneumovax is better with 23 stimulating antigens. The pneumococcal vaccine is slightly effective at lessening the incidence of otitis media and probably rhinosinusitis. It changes the infectious agent to non-typable hemophilis, which lessens the efficacy of the aminopenicillins.
Vitamins and Supplements
Zinc (zicam), vitamin C (up to 2,500 mg or 25,000 units per day), echinacea and other supplements remain unproven but certainly have no ill side effects. These can be administered either topically or systemically.
Papaya enzymes in a product called Clearease has been advocated by Dr. Grossan to be used in his Water Pik. Evidence is lacking and benefits seem subjective. A variety of herbal remedies have received attention. Echinacea is well known by many to help with URI’s. Some have advocated horseradish, bromelain, goldenseal, stinging nettle, ephedra and others. They seem harmless.
Forosemide (Lasix) and Pulmicort mixed in a cup of sterile water used as an irrigation have been touted to help some patients with chronic hyperplastic nasal polyposis. We do not have much experience with these methods. See the Topical Nasal Irrigations/Rinses page for options we recommend.
Anti-inflammatory drugs such as aspirin, ibuprofen, and cox-2 inhibitors have been touted by some to help with polypoid inflammation. Unfortunately, the side effects of these drugs can outweigh the benefits. See the Over-the-Counter (OTC) Medications page for information on other medications.
A number of devices to help keep the nasal valve open have been utilized. Most patients are familiar with Breathe Right strips. A similar device which fits inside the nose is Nose Brace. Quiet Night, Noseworks, and Sanostec also manufacture other intranasal devices, which patients find variably effective. They certainly pose little risk.
- Hot air or steam seems to have some positive subjective effects.
- A device called the Sinu-klean from Comtrad Industries uses a small amount of electrical current to theoretically stimulate sinonasal functions. However, it has not been proven effective or FDA-approved.
- The most refractory patients need to be evaluated for immune deficiency states as well as exocrine and cilia anomalies. The CF mutationa analysis is picking up lesser variants of this genetic disease.