Allergy, Nose & Sinus

Understanding Common Issues with Your Sinuses

June 30, 2021
girl with sinusitis

Introduction 

Sinuses are hollow cavities located within the skull and facial bones. We have four pairs of sinuses: sphenoid (beneath the nose), maxillary (cheeks), frontal (forehead), and ethmoid (between the eyes). Here are some important functions of our sinuses: 

  1. Since they’re hollow cavities, sinuses make our facial bones less dense and lighter. 
  2. They play an important role in shaping the quality of our voice production. Every person’s sinuses vary from others, and as such, we each have a unique voice characteristic. 
  3. They produce mucus to moisturise the inside of our nose and trap pollutants like dust, as well as bacteria. Our sinuses also contain little hairs known as cilia that sweep the mucus, along with the trapped pollutants, irritants, and bacteria, to the back of the nose. Hence, when you suffer from a cold or sinus infection, you may feel a post-nasal drip draining into your throat, resulting in a cough.

Sinusitis is an inflammatory condition affecting the spaces behind the face that lead to the nasal cavity, also known as the paranasal sinuses. It is one of the most common conditions in Singapore, especially since we live in a tropical climate.

However, many people are unaware of what happens to their sinuses when they experience symptoms of sinusitis. As such, they are unsure of how their condition should be handled, and what warrants a visit to an Ear Nose Throat (ENT) Specialist in Singapore. Hence, in this article, we will provide a more in-depth guide to sinusitis. 

 

Other serious complications of sinusitis

You may think that your sinusitis will go away on its own or that it is easier to bear with it than seek medical attention from an ENT Specialist in Singapore. However, as our sinuses are close to other organs in our body, like the brain and the eyes, leaving it untreated may cause serious complications in the future.

Untreated sinusitis can spread the infection to the eyes, causing redness, swelling, reduced vision, and even blindness. Eye complications from sinusitis can range from orbital cellulitis (infection of the eyes without accumulation of pus), orbital abscess (infection of the eyes with accumulation of pus) to a potentially life-threatening, but rare condition known as cavernous sinus thrombosis (infection leading to a blocked venous system in the middle of the brain with important nerves and vessels). As the sinuses are also close to the brain, severe sinus infections can spread to the brain, leading to life-threatening conditions such as meningitis or brain abscess. 

Although such complications are rare, it is still important to monitor your symptoms should you suspect that you have a sinus infection.

 

Managing Sinus

1. Natural Remedies 

 

Natural remedies for sinus infections are not able to fully cure your symptoms, but they can help to reduce them. Examples of these approaches include: 

  • Drinking plenty of water

Water helps to thin out mucus, making it easier to pass through your sinus passages. 

  • Eating well 

Boost your immune system by eating foods that are rich in vitamins and antioxidants to fight the free radicals that contribute to chronic sinus infections.

  •  Using a neti pot 

using neti pot in treating sinusitis

A neti pot is a small pot with a long spout. It can be used to rinse out the nose and keep the mucous membrane moist whilst relieving pressure in the sinuses. An important thing to note when using a neti pot is that it is ideal to use sterile or distilled water, and not tap water. However, if you are unable to get access to either, you can boil water and let it cool before using it to rinse out your nose.

  • Steam inhalation and warm compresses

Steam inhalation is effective in opening the passages in your nose to relieve sinus pressure. You can do this easily at home using a large bowl of steaming, boiled water. Simply position your face directly above the water, cover your head with a towel, and breathe through your nose. 

Alternatively, you can apply heat to the sinus area by laying a warm compress on your nose bridge and cheeks for a few minutes to relieve pressure. 

  • Reduce stress 

Prolonged stress can weaken your immune system, making you more susceptible to falling ill. Stress-related infections can attack and break down the cilia in your nose. Without cilia to trap pollutants and bacteria, it increases the risks of your sinuses becoming infected. 

Do regular exercise, eat healthily, use breathing techniques, and get sufficient sleep to reduce daily stress and improve your well-being.

girl treating sinusitis through exercise

 

2. Medical therapies

 

 Your doctor or ENT Specialist in Singapore may prescribe medications to treat the underlying cause(s) and reduce inflammation within your sinus passage. Depending on the underlying cause of your sinus infections, medical therapies may include: 

  • Corticosteroids

The first-line treatment for chronic sinusitis is usually intranasal corticosteroids. These are nasal sprays that you need to use regularly for a period of time to reduce inflammation within the nasal passages. They reduce swelling within the nasal passages so that mucus can exit the nose easily. As such, blocked noses are cleared to improve breathing.

Oral corticosteroids may be prescribed in patients with inflammatory polyps but are not generally recommended for chronic sinusitis without nasal polyps. 

  • Decongestants

One of the main symptoms of sinus infections is a blocked nose. Hence, your doctor may prescribe decongestants to unblock the sinuses and reduce the symptoms of nasal congestion. There are two kinds of decongestants available: nasal sprays or oral medications.

However, it is not recommended to use nasal decongestant sprays for more than five consecutive days as it may cause rebound congestion and worsen your blocked nose.

  • Antibiotics

In  acute viral or early bacterial sinus infection, symptoms can go away on its own without antibiotics. However, if your symptoms worsen after 5 days or persist longer than 10 days, your ENT Specialist may prescribe antibiotics to treat your infection. 

A common mistake made by many patients on antibiotics is that they stop taking them once they notice that their symptoms are improving. This is not recommended as it exacerbates the bacterial infection, preventing it from fully resolving. 

  • Saline irrigation 

Saline irrigation, also known as sinus rinse, uses salt water or a saline solution to flush out the mucus in your nasal cavity and sinuses. 

  • Surgical procedures

Your ENT Specialist  will recommend surgery only if your sinusitis does not improve with conservative treatment. In the past, sinus surgeries often required external cuts in the face. However, with the advancement of technology, less invasive surgical approaches can be carried out to enlarge sinus cavities and make breathing, as well as drainage easier.  

1. Functional Endoscopic Sinus Surgery (FESS)

FESS is a surgical approach used to treat chronic sinusitis. In this procedure, you will be put under general anaesthesia, and a special tool with a lighted camera on the end is used to look at the inside of your nose. The ENT surgeon will then either remove anything that is obstructing the affected sinus, such as nasal polyps or bony partitions. This helps to widen your sinuses allowing you to breathe better. 

Read more about FESS here: http://drganent.com/blog/functional-endoscopic-sinus-surgery/ 

2. Balloon Sinuplasty 

In this surgical procedure, the ENT Specialist will insert a small, balloon-tipped catheter into your sinus passages. Through the use of imaging guidance, the catheter is shifted to the right location before the balloon is slowly inflated. The balloon inflation widens your sinus passages, and once this is complete, it is deflated and the catheter is removed. Since this surgical approach does not require any tissue to be cut-out, the recovery time is generally shorter. 

This procedure is, however, not suitable for everyone with chronic sinusitis. Hence, it is always best to discuss your options with your ENT Specialist before deciding on the appropriate course of treatment for your condition.

Conclusion

Even though sinusitis is a nasal condition, it also has a big impact on other parts of your body. Hence it’s always recommended to seek medical attention from an ENT Specialist to better understand the condition you are facing.

Medically reviewed by Dr Gan

A Specialist Clinic for Sinus, Snoring & ENT is located at Mount Elizabeth Novena and is helmed by Dr Gan, an ENT Specialist in Singapore. Together, we work hard to determine the root cause of your sinus issues and provide treatments for lasting relief. Contact us today to find out more. 

References: 

https://www.stlsinuscenter.com/2020/11/15/do-you-understand-whats-happening-with-your-sinuses/

https://www.sinusreliefny.com/sinusitis-treatments/dietary-influences/

https://www.medscape.com/answers/302460-86832/what-are-the-potential-complications-of-sinusitis

https://www.sleepbetterny.com/whats-the-connection-between-sinusitis-and-sleep-apnea/

https://www.healthline.com/health/chronic-sinusitis

http://drganent.com/blog/sinusitis-complete-guide-ent/

https://www.alaskasleep.com/blog/5-reasons-why-your-nose-is stuffy#:~:text=Problem%20%235%3A%20Poor%20Sleep& text=But%20the%20most%20common%20reason,suffer%20relentlessly%20from%20nasal%20congestion

https://www.uclahealth.org/vitalsigns/chronic-sinusitis-has-impacts-beyond-a-runny-nose

https://www.moh.gov.sg/docs/librariesprovider4/guidelines/cpg_management-of-rhinosinusitis-and-allergic-rhinitis.pdf 

    When Should You See an ENT Specialist in Singapore?

    • Any ear, nose or throat symptoms that you are troubled with or concerned about
    • Persistent blocked nose with mouth breathing or snoring

    Dr Gan Eng Cern

    Dr Gan Eng Cern is a distinguished ENT doctor with fellowship training. In addition to his clinical practice as an ear, nose and throat specialist in Singapore, Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

    Awards

    • 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
    • 2016 – Best Educator Award (Eastern Health Alliance)
    • 2016 – “Wow” Award (Patient Compliment)
    • 2014 – Eastern Health Alliance Caring Award – Silver
    • 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
    • 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
    • 2007 – Singhealth Best Doctor Award

    Qualifications

    • MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
    • MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
    • MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
    • FAMS – Fellow of the Academy of Medicine Singapore

    Why Choose Dr Gan Eng Cern

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    Experienced and patient ENT Specialist who has your best interests at heart. We aim to provide you with accessible and specialized care for any ENT condition in a comfortable setting.

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    Our ENT Specialist, Dr Gan Eng Cern, will be able to diagnose and offer personalised treatments for your specific ENT condition. You can expect a high level of ENT care in a spacious setting with in-house minor surgical, endoscopy, allergy testing and microscopy services.

    4

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    There are various financial options available for you to ensure that you are able to receive the most optimal treatment and care. Our ENT clinic staff will be able to assist you with your medical insurance claims and work with your chosen healthcare organization to minimize the hassle and paperwork required. In some cases, you may be able to utilise the funds in your Medisave account to defray part of the costs of your treatment. As our clinic is accredited by the Medisave board, we are able to process your claims from your Medisave for certain clinic procedures.

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