Sinus Infection (Sinusitis): Causes, Symptoms, Diagnosis, Treatment & Surgery

What is sinusitis?

Sinusitis is an inflammation of the sinuses. Sinuses are air spaces within our face and skull base. They lighten our head, contribute to resonance and more importantly produce mucus that moisturizes our nose.

Sinusitis Treatment, Causes & Symptoms
Normal Sinus vs Infected Sinus
CT scan of normal sinus vs an infected sinus

What causes sinusitis?

Sinuses are linked to the nose via openings called ostia. When these opening are blocked, mucus is trapped within the sinus leading to a secondary bacteria infection. This is the cause of most acute sinusitis. Chronic sinusitis is sinusitis that lasted beyond 12 weeks. Causes of chronic sinusitis are more complex. It is often due to a combination of causes on top of infections. Other contributing causes are nose allergy, structural problems (e.g. deviated septum), nose polyps, and a weakened immunity, etc.

What are the signs and symptoms?

Common symptoms are nasal and sinus congestion, coloured or even blood stained nasal discharge, facial pain and fever. Other symptoms include poor sense of smell, eye discomfort and swelling, headaches and cough. Sinusitis can occur in both adults and children.

How does a sinus doctor diagnose sinusitis?

A sinus specialist will take a thorough history including the past history of allergy, asthma and allergic rhinitis. He will ask about your past sinus treatment and outcome. Our sinus specialist Singapore surgeon will encourage you to bring your previous investigations. A thin scope will be inserted into the nose to evaluate the sinuses. This procedure is often painless. Sometimes a nose swab will be performed to determine the type of organism causing the sinus infection. Other investigations that may be performed include a CT scan and an allergy test.

Picture showing pus from infected sinuses

Can sinusitis be cured with surgery?

Occasionally, sinus surgery may be performed to remove the disease improve the drainage of sinus and sometimes delivery of medications. Some diseases may need a period of close monitoring and treatment in order to achieve control and cure. Regardless, our sinus specialist will walk the journey with you.

Who is a sinus surgeon

A sinus surgeon is an Ear Nose Throat doctor who specializes in treatment of sinus diseases not limiting to infections. A sinus specialist is proficient in the treatment of uncommon sinus diseases such as fungal balls, nasal polyps, barotrauma and even tumour arising from the sinuses (E.g. inverted papilloma). He is equipped with special skill sets to perform safe and effective sinus and skull base surgery.

What happens during a sinus surgery?

During a sinus surgery, endoscopic instruments are used to remove thin bony partitions call ‘cells’ to unblock the drainage pathway of the sinuses. Trapped mucus is removed. Swelling such as polyps, papillomas and fungal concretions are carefully removed without compromising the function of the sinus.

Picture of nasal polyps and inverted papilloma

Is sinus surgery safe?

Sinus surgery is general safe under the hands of a highly trained sinus surgeon. The risk of injury to the eye, skull base and vessels is further reduced with the use of high definition TV system, highly precised instruments, image guidance surgery and a well-trained sinus specialist. Hence these complications are not common nowadays.

Risk and complications of sinus surgery

Risk and complications are generally low. It is expectant to have some congestion and bloodstained discharge after surgery. Occasionally, there may be tearing and ear block which are temporary discomfort due to the post op congestion.

Risk of sinus surgery include bleeding, loss of smell, injury to the eye (double vision, eye swelling, bruising around the eye, blindness, etc), and injury to the skull base (cerebrospinal fluid leak, meningitis, brain abscess, etc).

Fortunately, these complications are very rare under expert hands. Depending on the nature of disease, some may have a risk of recurrence. Loss of smell may occur if the disease arises from around the region of the smell sensory organ.

Types of sinus surgery

Nowadays, most sinus surgeries are performed through endoscopes. There are 4 major sets of sinuses i.e. frontal, sphenoid, maxillary and ethmoid sinuses. The type of surgeries performed depends on the sinus involved and the extent of disease. Our sinus specialist will formulate the best and most appropriate sinus surgery based on your
condition.

Sinus surgery recovery (post-surgery)

Sinus surgery is usually pain-free. There will be nose congestion and blood stained nose discharge. But our patients are usually able to eat and drink on the same day. Some may even be discharged on the same day. Our sinus doctors will monitor your recovery closely to ensure that it’s smooth and comfortable. There will be regularly reviews to clean the wound until they heal.

Sinus Surgery - Post Op photo
Post sinus surgery photos of ‘opened’ sinuses
Image Guidance showing pointer at the skull base

How to choose the right sinus surgeon for sinus disease treatment?

ENT specialists or otolaryngologists are trained to treat most nose and sinus disease such as allergic rhinitis, polyps, sinusitis, deviated nasal septum and turbinate enlargement.

Singapore ENT Specialist who received additional sub-specialized training in sinus surgery is able to manage sinus infection and disease from a more holistic manner.

A trained sinus surgeon removes the disease and treats all related predisposing causes. It involves restoring the functions of the sinus. He would have spent additional years training and building specialized skills needed to operate in disease with complex anatomy.

A trained Singapore sinus surgeon is able to handle all complications arising from sinus surgery such as a CSF leak or a major bleeding.

When Do You Consult an ENT Sinus Specialist?

You should see an ENT Sinus Specialist in the following scenarios

a. Recurring episodes of sinusitis
b. Chronic sinusitis i.e. sinusitis more than 12 weeks
c. Sinusitis associated with complications e.g. eye swelling, double vision, severe headaches, forehead swelling, meningitis
d. Suspicion of sinus tumour e.g. blood stained, one sided, etc.
e. Cerebrospinal fluid leak
f. Sinusitis despite previous sinus surgery
g. Presence of unusual symptoms such as excessive crusting, foul smell from the nose (Cacosmia).

Why choose Ear, Nose Throat, Head & Neck Surgery

At Ear Nose Throat, Head & Neck Surgery, our surgeons are fully accredited Singapore ENT specialist with the Ministry of Health, Singapore. Additionally, Dr Lim Keng Hua is on the select list of ENT specialists who is accredited to perform complex sinus surgery. Dr Lim spent a year at the Academy medical center (Academisch Medisch Centrum) in Amsterdam subspecializing in Complex Sinus and Endoscopic Skull Base Surgery under his world-renowned mentors Professor Wytske Fokkens and Professor Christos Georgalas. Dr Lim is a member of the both the American Rhinologic Society and the European Rhinologic Society. At Ear Nose Throat, Head &Neck Surgery, you can therefore be assured that the specialist performing your sinus surgery has the credentials and experience to produce the results that’s the best for you.