Abstract
The primary aim of treatment of chronic sinusitis is to break the vicious cycle of sinusitis. Sinus surgery is a tool to attain this purpose and is one of the most effective measures to accelerate the healing process. Needless to say, postoperative care plays an important role. Mucociliary function is said to improve within 6 weeks to 3 months after the surgery; it, however, takes much longer until it becomes normal. Topical treatments, including nebulizer treatment are considered to be useful for wound healing during the postoperative period. From the viewpoint of nebulizer treatment, anatomic problems, such as a narrow ostiomeatal complex, hamper the penetration of aerosol particles into the sinuses. Thus, ways of increasing particle entry, such as application of a pressure gradient between the nasal cavity and the sinuses or enlargement of the ostial diameter, have been used for the treatment of chronic sinusitis. Surgery provides larger ostia and makes cleaning of rhinorrhea easy, which leads to improved deposition of aerosol particles in the sinuses, promoting the postoperative healing process.
Evidence on the value of nebulizer treatment in the postoperative management of paranasal sinusitis is presented. However, even a combination of endoscopic sinus surgery and nebulizer therapy does not appear to be effective for eosinophilic sinusitis at present. Further investigation addressing this issue is necessary.
