Adult Chronic Sinusitis and Its Complications

By G. Douglas Campbell Jr., MD, FCCP

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Medical Management of Chronic Rhinosinusitis

Decongestants

Decongestants, either systemic or topical, promote shrinkage of edematous mucosa by stimulating alpha-adrenergic receptors. They aid in thinning the mucus and have minimal drying side effects, but long-term use (> 5 days) is associated with rebound effects, and decongestants should be used with caution in patients who have certain medical conditions (ie, hypertension, ischemic heart disease, hyperthyroidism, diabetes) or are taking monoamine oxidase inhibitors. For this reason, short courses of topical decongestants, especially oxymetazoline hydrochloride, are frequently recommended.

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