Medical options other than antibiotics or corticosteroids for treating rhinosinusitis include non-specific treatments such as nasal decongestants, naso-sinusal washings, antihistamines, antileukotrienes, mucolytic agents, immunomodulators and immunostimulants, as well as specific agents such as antimycotics in fungal sinusitis or antireflux agents in sinusitis associated to gastroesophageal reflux. In subjects with chronic sinusitis and/or nasal polyposis related to aspirin hypersensitivity protocols of desensitization are available. The available scientific evidence is good for naso-sinus washings with saline solutions, antihistamines in acute allergic rhinosinusitis, antileukotrienes in chronic sinusitis, bacterial lysates for prevention of recurrent sinusitis, and aspirin desensitisation in subjects with aspirin-exacerbated respiratory disease with chronic sinusitis and nasal polyposis. The other treatment options are still in search of scientific demonstration.
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