Overview Of Sinusitis
Sinusitis is an infection that causes your sinuses and nasal passages to become inflamed, and is a common condition that affects millions of people globally each year.
What Are The Sinuses
A connected system of hollow cavities in the skull, the largest sinus cavities are about an inch, while the others are much smaller. Your maxillary sinuses are held by your cheekbones, your frontal sinuses are located at the low centre of your forehead, your ethmoid sinuses are between your eyes, while your sphenoid sinuses are located in the bones behind your nose.
One of the functions of the sinuses is to produce mucus, a slippery and stringy fluid substance, which acts as a trap for dust, smoke, and bacteria, as well as containing antibodies and bacteria-killing enzymes to help fight infections.
Sometimes, in the presence of too much bacteria or allergens, more mucus forms, which may block the openings of your sinuses.
While excess mucus is common when having a cold or allergies, this buildup of mucus can encourage bacteria or germs to accumulate in your sinus cavities, causing a bacterial or viral sinus infection.
As most sinus infections are viral, they go away within 1-2 weeks without treatment. However, if your symptoms don’t improve within 1-2 weeks, a bacterial infection may be present, and you should immediately consult an ENT specialist in Singapore.
Types Of Sinus Infections
Sinusitis can be classified into 3 different types based on its duration
- Acute Sinusitis: The most common type which lasts up to 3 months (see an ENT doctor)
- Chronic Sinusitis: Persistent symptoms that last longer than 3 months, or symptoms that continue to return after 12 weeks. Considered to be more severe, and patients may require sinus surgery
Symptoms of sinusitis may vary depending on the length of infection, and how severe it is.
Generally, if you have two or more of the following symptoms accompanied by thick, green, yellow nasal discharge, your ENT specialist may diagnose you with sinusitis:
- blocked nose
- nasal discharge
- facial pain and/or pressure
- reduced sense of smell
- nasal congestion
- prolonged coughing
You may be diagnosed with chronic sinusitis if your symptoms persist for 12 weeks or longer.
How Is Sinusitis Diagnosed?
Your doctor may gently press over your sinuses (on your face) to identify an infection and also look into your nose with a light to identify inflammation, polyps, or other abnormalities.
Using A Nasal Endoscope
For a more accurate diagnosis, your ENT specialist may perform a nasal endoscopy (“nose scope”), a procedure to take a closer look at the nasal and sinus passages. During the procedure, the endoscope will be inserted into your nose, and be guided through your nasal and sinus passages. Images of the areas will be able to be seen through the endoscope.
In some cases, your doctor may order a non-invasive CT scan or MRI to determine if there’s inflammation or other abnormalities in your nose or sinuses.
Sinusitis Risk Factors
A risk factor is something that increases your likelihood of getting a disease or condition. You should also know that it is possible to develop sinusitis with or without the risk factors outlined below.
You’re at increased risk of getting sinusitis if you have the following:
- Deviated nasal septum
- Nasal polyps
- Dental infections
- Immune system disorder or Autoimmune diseases
- Hay fever or other allergic conditions
- Regular exposure to pollutants such as carbon monoxide, nitrogen oxide, sulphur dioxide, and cigarette smoke
Treatment Of Sinusitis
The treatment for sinusitis depends on how long the symptoms last.Generally, acute viral or early bacterial sinusitis may resolve without antibiotics.
However, in the following scenarios, you should consult an ENT specialist:
- Your symptoms worsen on day 5 of your illness or last longer than 10 days
- You experience an extremely severe headache that does not go away with over the counter medication
- There is swelling or pain around your eyes
- Your symptoms persist even after taking medication prescribed by your general practitioner (GP)
In general, acute viral or early bacterial sinusitis may resolve without antibiotics. However, if your symptoms are more severe, your doctor may prescribe antibiotics.
Antibiotics help eliminate a sinus infection by attacking the bacteria that causes it, but until the drugs take effect, they do not do much to alleviate symptoms.
A typical course is usually between 7-21 days depending on your doctor’s instructions. Side effects include rashes, diarrhea or stomach issues.
Don’t stop taking your antibiotics earlier than instructed as this can allow the bacterial infection to fester and not be fully resolved. On the other hand, the overuse of antibiotics can lead to superbugs, which are bacteria that cause serious infections and cannot be easily treated.
Your doctor may have you schedule another visit to monitor your condition.
Sinus rinse is a salt water or saline solution that helps flush out the mucus in your nasal cavity and sinuses.
It can be made at home by mixing 1 cup of prewarmed water with ½ teaspoon of table salt and ½ teaspoon of baking soda. Then, spray it into your nose using a nasal sprayer or pour it into your nose with a neti pot.
It is important to perform the rinse at least twice a day until your symptoms resolve.
Nasal corticosteroids (nasal steroid sprays) are used to prevent and treat inflammation. They are also effective in shrinking and preventing the return of nasal polyps.
They are available over the counter or by prescription.
Your doctor may also direct you to rinse your nasal cavity with a saline solution mixed with a corticosteroid such as budesonide.
Oral corticosteroids are usually prescribed if you have nasal polyps or a severe case of sinusitis. They are typically only used to treat severe symptoms.
Antifungal drugs can be prescribed to treat a fungal infection but this is rarely needed.
Allergies can be treated with antihistamines or allergy shots. Avoiding exposure to allergens in general can reduce the occurrence of allergic sinusitis
If you aren’t responding to the above treatments, your ENT specialist may opt to perform functional endoscopic sinus surgery (FESS).
FESS is usually performed under general anesthesia (when you’re asleep) and patients can often go home on the same day.
During the procedure, the surgeon will insert an endoscope into your nose. It is a thin tube with a lens at one end that magnifies the inside of your nose. It allows the surgeon to see the opening of your sinuses and insert small surgical instruments.
What To Expect During Your Visit To An ENT Specialist?
A visit to an ENT specialist or otolaryngologist is usually different from an average visit to your family physician, as the specialist may use instrumentation to allow better visualization of your sinuses.
Typically, a medical history is taken eliciting the symptoms of the patient’s complaints.
A thorough examination of sinuses is usually performed. Depending on your presenting complains or the nature of your condition, a nose scope (nasendoscopy) may be required. A nasendoscopy is a simple and relatively painless procedure which is performed under local anaesthesia (a spray to numb and decongest the nose will be applied). This is done in the clinic and takes less than 5 minutes.
Other investigations such as blood tests, imaging (X-rays, CT scans, MRIs etc) and laboratory tests (e.g. bacterial culture and biopsy tests) may be arranged if deemed necessary by our ENT Specialist.
Is The Treatment of Sinusitis Covered by Medisave or Medical Insurance?
The assessment of Sinusitis usually requires a nasal endoscopy, which is performed in the clinic. This is considered a Day Surgery (Hospitalization) procedure.
The costs of consultation and medical treatments following a nasal endoscopy are usually insurance (if you have the appropriate health insurance) or Medisave claimable.
We provide E-filing (Electronic Filing) services for patients with Medisave or health insurance plans that meet the appropriate criteria. You should speak to our friendly clinic staff who will be able to assist with your enquiries on insurance or Medisave claims.