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Treatment of sinusitis depends on whether the problem is acute (short-term and more severe) or chronic (long-lasting and more mild).

Acute sinusitis often resolves on its own without the need for treatment. If treatment does become necessary, decongestants may be prescribed to open the sinuses and reduce the volume of mucus that is present. A course of antibiotics over 10 days to two weeks is usually successful in curing an infection caused by bacteria.

Chronic sinusitis can be more difficult to treat. Many different medications may be necessary to successfully treat this condition. These medications may include antibiotics (when bacterial infection is involved), decongestants, mucus-thinning medications, and antihistamines or anti-inflammatory corticosteroid nasal sprays (both of which are used to reduce swelling and mucus production). For patients using nasal sprays, physicians may recommend using a saltwater or saline wash before the spray to help remove mucus and bacteria from the nose and sinuses.

There are some concerns about using corticosteroid nasal sprays to treat chronic sinusitis for long periods of time, because the long-term effects of these medications are not known. Therefore, a physician will weigh the potential benefits and risks of such medications before prescribing them. Nasal corticosteroid sprays are usually preferred to oral corticosteroids because they affect one localized area of the body, while systemic medications such as pills or liquids may affect the entire body. Nonetheless, oral corticosteroids may be prescribed in cases of severe sinusitis.

In some cases, allergy shots (immunotherapy) may be helpful in reducing sensitivity to certain allergens for people with chronic allergic sinusitis.

Over-the-counter pain relievers may be recommended for patients with sinusitis. These medications may help relieve sinus headaches and lessen fever. Patients should always consult with a physician before taking any type of medication, including over-the-counter remedies.

Some physicians may recommend alternatives to medications that may help alleviate symptoms associated with sinusitis. These techniques help to keep nasal passages moist, which can reduce nasal congestion. These non-drug techniques may include:

• Breathing in hot, moist air – such as from steaming water in a bowl – for 10 minutes two to four times a day. Patients should wear a towel over their heads to prevent the steam from escaping.
  
  
• Applying hot packs to the face, which helps to ease facial pain.
  
  
• Rinsing nasal cavities with saltwater solutions. This can help remove mucus and bacteria from the nose and sinuses.

For some patients, surgery may be necessary to treat sinusitis. This is more common in adults with a physical abnormality that is responsible for symptoms, such as nasal polyps (small, grape-like growths), crookedness in the wall dividing the nostrils (deviated septum) or other physical problems. It may also be used as a last resort when medications have failed. During surgery, the natural openings of the sinuses may be enlarged to facilitate drainage. A thin, flexible tube called an endoscope is used, and serious complications are rare.

In children, the removal of nose and throat lymphoid tissue known as the adenoid often eliminates the blockage causing problems.

Patients who suffer from some forms of fungal sinusitis may require surgery to remove the fungus and prevent damage to the sinuses, eyes or brain.