The perioperative treatment of sinusitis is very important, even more than the surgery itself.
This treatment includes preoperative and postoperative components. Preoperative routine antimicrobial plus hormones, which can be used for a week when conditions permit, has three benefits: it relieves local inflammation and reduces the extent of the lesion; it reduces intraoperative bleeding; and it clarifies the boundary between the lesion and normal tissue to avoid excessive excision. There is no shortage of patients who have been spared surgery because their condition has improved with regular medication. Postoperative treatment includes regular cleaning of the operative cavity (endoscopic cleaning), as well as longer-term drug therapy. A long-term combination of small doses of macrolide antimicrobials and nasal spray hormones, as proposed in the 2007 European sinusitis guidelines, is currently recommended.