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you need to go to an ENT and get a CT Scan of your sinuses scheduled. Don't worry, the procedure takes 10 minutes, and is painless.

It sounds like you may have a structural defect within the nose or sinuses that is causing improper drainage, and subsiquent infection. Structural problems are things like a deviated septum, broken nose when your were a kid, or maybe a polyp. The only way to correct this is through sinus surgery.

Antibiotics do a very poor job in treating sinus infections. I would estimate that they have about a 60% failure rate. This is because the sinus cavities have very little blood flow. They are basically air pockets of bone. One method that might work better, is to use an antibiotic mist delivered using a nebulizer or spray bottle from a company like Sinucare.

Sinus infections become chronic in people with structural problems (like myself). If you suffer from repeat, severe infections, that don't respond to antibiotics, you may need to do the following...

1. Consult an ENT and see if surgery is warrented. This may consist of something called a "FESS" or frontal endoscopic sinus surgery, which is a procedure to directly clear out the bacteria, and a "NAR" or nasal airway reconstruction, in which the septum is straightened, passages are enlarged, etc. The surgeon may also do a turbinate reduction. This surgery has a quick recovery, and very little pain -it is NOTHING to worry about. You might stay a night in the hospital. Once it has been done, your sinus problems should decrease by 90-100% for the rest of your life.

2. But surgery is not the last step. You will have to engage in a "irrigation routine", in which you use a machine or spray bottle to irrigate your sinuses twice a day for 6 months, and then once every couple days thereafter. I use something called a Grossan Hydropulse machine, and it works great. Another poster named "Beerzoids" has a method using a spray bottle, which works fine. Both of us advocate the use of hydrogen peroxide in very low doses to combat bacteria and allergens in the sinus cavities. I also swear by Zyletol, a OTC product that works better than saline. My "magic formula" is...
a) 480ml of COOL distilled water, NOT warm.
b) 3ml of hydrogen peroxide, IF my nasal discharge is yellow or green.
c) a tablespoon of Zyletol or Kosher salt.
d) 10ml of Alkalol, a mucus solvent you can buy from Walgreens, etc.

This irrigation method will both prevent infection, and combat infection. I had a sinus infection 5 months after surgery, and I irrigated using the mixture above for a couple days, and it was 100% gone after that. No antibiotics, not even an OTC med. Just irrigation.

3. Figure out where the inflammation is coming from. You might have nasty allergies to things like dust mites. See an allergist and get into some immunotherapy -it's very important, and it works.

4. Avoid caffeine -it swells the sinuses. Also cut down on alchohol until the sinus problems are resolved, since it does the same thing.

One word on antibiotics: some are very dangerous. They are called Floroquinolones, and the brand names are Avelox, Cipro, Levaquin, and Tequin. Please do NOT take these medications. They have severe, even permanent, debilitating side-effects, like tendon ruptures, vasculitis, peripheral neuropathy, etc. I took Avelox for my sinuses and ended up with nerve damage in my feet and elbows, vasculitis in my hands, and chronic tendonitis. 2 months later, a friend of mine (a nurse) took Levaquin for a UTI and ended up int the ER with her skin burning off her chest and face -something called Stevens Johnson Syndrome. She was in intensive care for 4 months and almost died. She, too, has nerve damage.

There are safe antibiotics out there, like Augmentin, Amoxicillan, and Penicillan -just stick with those.

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