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We have several small air-filled spaces located within our skull, behind our cheeks, between our eyes and over our forehead. These spaces are called sinuses, and they help to moisturise and warm the air we inhale. They also help to make our voice bright and resonant when we speak.

Mucus is produced in our sinuses which drain into our nasal cavity. When these channels are blocked, pressure builds up in our sinuses, causing pain or discomfort.

It is common for us to get acute sinusitis after a viral upper respiratory tract infection (flu or cold). While most of us will recover on our own, some may require antibiotics.

Sinuses are hollow cavities located within the skull and facial bones, right beneath the nose (sphenoid), cheeks (maxillary) and forehead (frontal), and between the eyes (ethmoid). They have several important functions:

  1. Sinus are hollow structures that make our facial bones lighter.
  2. They serve as resonating chambers for voice production. Because our sinuses are different from other people, each one of us have our own unique voice characteristic because of this.
  3. Sinuses produce mucus which moisturize the inside of the nose. They contain little hair cells (cilia) which sweep the mucus along with trapped pollutants, bacteria and other irritants away. The mucus is swept to the back of the nose and swallowed. That is why when we have a cold or sinus infection, we feel a post nasal drip which drains down into our throat and makes us cough more.

Common colds, allergies and viral infections and block up our sinus passages into our nose and cause mucus build up. The increased pressure within our sinuses will give rise to heavy-headedness, dizziness, pain, clogged nose and fever.

Sinus problems range from mild, going away on their own within days or weeks, to severe, requiring antibiotics or even surgery. They are very common, with 90% of adults most likely to contract a sinus condition at least once in their lifetime. In Singapore, sinus problems are more persistent than recurrent because of the tropical climate.

Causes

The most common reason for getting sinusitis is after a flu or cold.

Other conditions that make us prone to getting sinusitis are:

  1. Nasal polyps
  2. Allergic rhinitis
  3. Smoking
  4. A weak immune system
  5. Working in an environment with toxic fumes (e.g. painting, chemicals, glue)
Symptoms

Symptoms of sinusitis include:

  1. Nasal obstruction
  2. Yellow or green nasal discharge
  3. Pain or discomfort behind the cheeks, forehead and behind the eyeballs
  4. Toothache
  5. Reduced sense of smell
  6. Bad breath

Children with sinusitis may appear irritable or breathe through their mouth.

Acute sinusitis usually clears up spontaneously or with treatment within 3 months. However, if the sinusitis persists beyond 3 months, it will be considered chronic sinusitis.

When to See a GP

It is common to have acute sinusitis after a flu or cold. The symptoms should subside within 7-10 days. You should see your GP if the symptoms persist or if they get worse.

When to See an ENT Doctor
  1. Frequent attacks of sinusitis every year
  2. Sinusitis that does not respond to antibiotics
  3. Bloodstained nasal discharge
  4. Redness and swelling of the eye and blurring of vision
  5. Intense headaches
  6. High swinging fever
Treatment

If your symptoms are mild and occur immediately after a cold, you can try simple remedies like Panadol to relieve the pain and nose drops to decongest the nose. You can also apply a warm pack over your face to reduce the discomfort.

Other treatment methods include:

  1. Antibiotics
    1. Sinusitis that does not resolve on its own is usually associated with secondary bacterial infection. A course of antibiotics will often clear up the symptoms
  2. Nasal douche
    1. Douching or rinsing the nose with sodium bicarbonate solution helps to wash away the infection, reduce the congestion and promote healing
  3. Nasal steroid sprays
    1. Nasal steroid sprays are very effective in reducing inflammation and swelling and bring about symptomatic relief
Surgery

See an ENT surgeon if you have recurrent sinusitis that does not respond to antibiotics.

The ENT surgeon will examine your nose to see if you have any nasal polyps or structural problems that predispose you to sinusitis. Sometimes a CT scan may be used for a more accurate diagnosis.

Is some instances, sinus surgery (Functional Endoscopic Sinus Surgery, or FESS) may help promote drainage of the sinuses:

  1. Performed under general anaesthesia
  2. Removes diseased sinus cells and opens up the natural drainage pathways between the sinuses and the nasal cavity
Recovery
  1. 1-2 weeks of medical leave after the surgery
  2. Return for post-operative cleaning
  3. Douche your nose frequently to keep the operated area clean
  4. Most patients will recover within a month

Run by Dr Paul Mok, My ENT Specialist is an established sinus clinic in Singapore specializing in the management of ENT conditions such as sinus infections, nasal allergies, ear problems, salivary gland disorders, laryngitis, sleep apnea and more. To schedule a consultation, call 6397-5280.

Know Your ENT Specialist
Dr Paul Mok
Senior Consultant ENT Surgeon
MBBS, FRCS (Glasgow), FAMS (ORL)

Dr Paul Mok Kan Hwei is a certified specialist in Otolaryngology, Head and Neck Surgery (ENT) and has had a distinguished career in public service for the past 23 years.

He cares for patients with a wide variety of ENT conditions including managing patients with nasal allergies, sinus infections, ear problems and swellings in the head and neck region. His special areas of interests are in Voice, Swallowing and managing patients with Obstructive Sleep Apnea.