Did you know that “sinus conditions”, such as stuffy nose, sniffles, sneezing and the loss of smell, are very common in Singapore? These symptoms can be a red flag that an individual may have a viral infection, allergic rhinitis or rhinosinusitis – the three key causes of nasal obstruction. Making things worse, sinus problems are often exacerbated by Singapore’s humid climate and pollution as well as personal exposure to common allergens like dust mites and pollen.
Chronic sinus problems can significantly lower one’s quality of life, leading to symptoms such as nose congestion, headaches, facial pain, and sleep disturbances. For some individuals, sinus surgery is a necessary solution because other less invasive treatments have not been effective.
In this blog article, Dr Ker Liang, Aglow ENT Centre’s Medical Director and Consultant Otolaryngologist, leverages her expertise in sinus surgery to write a guide to what every sinus patient should know.
This comprehensive guide explores sinus problems, treatment options, and essential considerations when seeking sinus surgery in Singapore while incorporating research findings for a comprehensive, evidence-based perspective.
What Are Your Sinuses?
Your sinuses are air-filled cavities around the nasal passages that help with air humidification and mucus secretion. They’re lined with a thin layer of tissue that produces mucus. Mucus keeps the nasal passages moist and traps dust, allergens, and other particles, preventing them from entering the lungs and causing infections.What Are the Common Sinus Problems in Singapore?
Sinus problems usually involve inflammation, infection, or structural problems in the sinuses. Studies show that sinus conditions, particularly chronic sinusitis (also known as chronic rhinosinusitis), are widespread in Singapore.
Prevalent sinus problems in Singapore include:
1. Chronic Rhinosinusitis (CRS):
A condition characterised by long-term inflammation of the sinuses and nasal passages, typically lasting over 12 weeks.
Sinusitis with pus tracking into the back of nose and throat
Sinusitis with pus in the nasal cavity
CRS is often associated with nasal polyps, which worsen the obstruction of airflow.
2. Nasal Polyps
Non-cancerous growths in the lining of the nasal passages or sinuses, which can further exacerbate sinusitis symptoms by obstructing airflow and blocking drainage.
What Are the Symptoms of Sinus Problems?
Symptoms of sinus problems include:
- Nasal Congestion: A common complaint where blocked airways lead to difficulty breathing.
- Facial Pain and Pressure: Often concentrated around the nose, forehead, and eyes due to inflamed sinuses pressing against surrounding areas.
- Headaches: Resulting from increased sinus pressure and inflammation, headaches are a common symptom of both acute and chronic sinusitis.
- Nasal Discharge: Coloured discharge, often yellow or green, is associated with infection and inflammation.
- Reduced Sense of Smell or Taste: Nasal congestion and sinus blockage reduce sensory perception.
- Post-Nasal Drip: Mucus drainage down the throat can lead to sore throat, coughing, or throat clearing.
- Sleep Disruptions and Fatigue: Persistent sinus conditions can disrupt sleep, resulting in daytime fatigue and reduced concentration.
A study by Alt and Smith published in the International Forum of Allergy & Rhinology found that chronic sinusitis symptoms undermine sleep quality and overall well-being. This highlights the importance of timely diagnosis and treatment from a nose specialist in Singapore.
What Causes Chronic Sinus Problems?
In Singapore, multiple factors can increase one’s risk of developing long-term sinus problems, including:
- Allergies: Dust mites, mould spores, and pet dander are major allergens. Dust mite sensitivity is particularly strong in Singapore, likely due to the country’s tropical climate and high indoor humidity levels. This could, in part, explain the high prevalence of allergic rhinitis in Singapore. As reported by SingHealth’s Healthxchange, allergic rhinitis affects 24% of Singapore’s population.
- Environmental Irritants: The country’s dense urban environment contributes to pollution, which can irritate the sinus passages and aggravate existing conditions.
- Structural Nasal Conditions: Conditions like a deviated septum or nasal polyps prevent proper drainage, creating a breeding ground for infection and inflammation.
- Immune Responses: People with asthma or immune system deficiencies are more prone to chronic sinusitis.
These underlying causes can create a cycle of inflammation and infection, leading to chronic symptoms that may require medical or surgical intervention. Patients with chronic rhinosinusitis have a heightened susceptibility to airway inflammation, which may be aggravated by Singapore’s air quality and high allergen exposure.
What Are the Common Complications of Sinusitis?
If left untreated, acute sinusitis may lead to the following complications:
- Chronic Sinusitis: Acute sinusitis can be a flare-up of a long-term problem called chronic sinusitis. Chronic sinusitis persists longer than 12 weeks.
- Meningitis: Though rare, untreated sinus infections can spread, leading to inflammation of the brain and spinal cord’s protective membranes.
- Other Infections: An infection can spread to the bones, called osteomyelitis, or to the skin, called cellulitis.
- Vision Problems: Severe sinus infections, particularly those involving the ethmoid sinuses, can compromise vision due to proximity to the eyes.
These complications underscore the importance of prompt diagnosis and treatment by a sinus doctor in Singapore to prevent long-term health risks.
How do Sinus Problems Affect the Voice?
Did you know that our sinuses not only moisturise and filter air, but also enhance voice resonance? Sinuses act as resonating chambers, helping to amplify and improve the sound of your voice, giving it depth and tone. When the sinuses are inflamed or blocked, they disrupt normal airflow and affect the resonance in your voice, leading to changes such as:
- Nasal or “Stuffy” Sound: Blocked sinuses force you to breathe through your mouth, reducing airflow through the nasal passages and giving your voice a muffled, nasal quality.
- Loss of Voice Resonance: Healthy sinuses act as natural “echo chambers” that add depth and richness to your voice. Sinus congestion reduces this resonance, making your voice sound flatter or less vibrant.
- Throat Irritation and Hoarseness: Post-nasal drip (mucus draining down the back of the throat) can irritate the vocal cords, causing hoarseness, frequent throat clearing, or even a scratchy voice.
For individuals who rely on their voice professionally, such as singers or speakers, persistent sinus conditions can be particularly disruptive, sometimes requiring medical intervention to restore normal voice quality.
Who Should I Consult for Sinusitis?
Although milder cases of sinusitis typically resolve on their own or go into remission after treatment from a general practitioner (GP), moderate to severe cases of sinusitis often warrant a visit to an ENT (Ear, Nose, and Throat) specialist.
If you have recurring sinus symptoms that last for more than 12 weeks (3 months) or if you experience frequent sinus infections (more than three or four times a year), it’s advisable to see a sinus doctor in Singapore. Chronic sinusitis, which persists beyond 12 weeks, often requires evaluation by an ENT specialist to identify underlying causes and develop an effective treatment plan. ENT specialists (also known as otolaryngologists) are medical doctors specialising in the diagnosis and treatment of sinusitis, with expertise in both medical and surgical management of sinus conditions.
1. General ENT Specialists
General ENT specialists are trained to diagnose, treat, and manage a wide range of conditions related to the ear, nose, throat, and associated areas of the head and neck. They are versatile professionals capable of addressing both common and complex issues within their scope of expertise. General ENT specialists typically do not focus on a specific subspecialty but provide comprehensive care across the ENT spectrum.
2. ENT Specialists with a Subspeciality in Laryngology
In particular, it is often beneficial for people with sinus problems that affect their voice to consult an ENT specialist with a subspecialty in laryngology. Laryngologists are ENT specialists who focus specifically on disorders of the larynx (voice box), vocal cords, and other voice-related structures. For patients whose sinus problems are impacting their voice, a laryngologist can provide a comprehensive evaluation that considers both the sinuses and the voice, offering treatments tailored to address vocal quality, resonance, and any related throat conditions.
Laryngologists often work with patients who experience:
- Post-Nasal Drip: Frequent sinusitis, causing throat irritation and affecting the vocal cords.
- Chronic Hoarseness or Vocal Fatigue: Sinusitis-related conditions like nasal congestion and post-nasal drip can strain the vocal cords, leading to hoarseness and fatigue. Breathing through the mouth due to nasal blockages from sinusitis can also dry out the throat and vocal cords, further increasing vocal strain.
At Aglow ENT Centre, an ENT specialist clinic in Singapore’s Mount Elizabeth Hospital (Orchard), our patients can receive expert treatments to alleviate sinus and voice-related conditions simultaneously. This is because our esteemed ENT specialist, Dr Ker Liang is not only well-versed in all general ENT conditions but also has a subspeciality in Laryngology.
Can an ENT Doctor Clean Out Your Sinuses?
An ENT doctor can clean out your sinuses using specialised techniques, such as nasal irrigation, suctioning mucus and sinus drainage. These processes are often part of the treatment for conditions like chronic sinusitis, severe nasal congestion, or sinus infections where mucus and debris accumulate in the sinuses and do not drain properly.
Is Surgery Always Needed to Fix Chronic Sinus Conditions?
In Singapore, there are various treatments for sinus problems. Uncomplicated chronic sinus conditions typically do not require surgery. This is because many patients find symptom relief through non-surgical treatments, including:
- Medication: Antibiotics, antihistamines, and corticosteroids are used to reduce inflammation and manage symptoms.
- Nasal Irrigation: A saline rinse can help clear nasal passages, which is particularly effective in reducing nasal congestion and drainage.
- Lifestyle Adjustments: Using air purifiers, avoiding allergens, and practising steam inhalation can improve symptoms.
For instance, a study in the Allergy & Rhinology (Providence) journal reported that medical therapy provided sufficient symptom relief in roughly one-third of patients with chronic rhinosinusitis. Therefore, surgical therapy was not necessary for them.
Nonetheless, it is advisable for patients with severe sinus conditions to consider surgical intervention if less invasive treatments do not work well. At Aglow ENT Centre, our sinus specialist doctor will provide you with a tailored treatment plan, closely monitor the effectiveness of the treatment(s), and advise you on whether surgery is recommended.
What Are the Benefits of Sinus Surgery?
Sinus surgery aims to open blocked sinus passages, improving drainage and reducing inflammation. Benefits of sinus surgery usually include:
- Enhanced Nasal Breathing: By removing obstructions, surgery can enhance airflow and reduce congestion in the nose.
- Reduced Frequency of Sinus Infections: Surgery addresses structural conditions that predispose patients to sinus infections.
- Higher Quality of Life: Many patients report significant improvements in sleep, energy levels, and reduced dependency on medications.
However, surgery may not fully prevent sinusitis recurrence, especially if environmental triggers or allergies remain. We will evaluate whether surgery is likely to provide a lasting solution and also provide handy lifestyle tips to effectively address the root cause(s) of your sinus inflammation.
Aglow ENT Centre’s experienced and skilled sinus surgeon in Singapore, has deep expertise in both medical and surgical treatments for all sinus conditions. Her sharp surgical skills have enabled numerous sinus patients to recover well, significantly increasing their quality of life.
Is Sinus Surgery Safe?
Sinus surgery is generally safe when performed by a skilled ENT surgeon, such as Dr Ker Liang. However, as with any surgical procedure, there are potential risks. Common side effects may include mild bleeding, facial discomfort, swelling, and nasal congestion. These symptoms are usually temporary and tend to subside within a few weeks. Severe complications are rare but can occur, such as ongoing sinusitis or, in very uncommon cases, damage to nearby structures like the orbital wall or the base of the skull, given the close anatomical relationship of the sinuses to these areas.
The likelihood and intensity of these side effects largely depend on factors such as the patient’s overall health, the severity of the condition, and the surgical methods employed.
The overall complication rate for endoscopic sinus surgery is low, particularly when performed by experienced ENT surgeons. Most complications are minor, and the success rates for symptom relief are high, making it a safe low-risk option for patients needing long-term relief.
Is a Sinus Operation Painful?
During the Procedure
Sinus operations, such as Functional Endoscopic Sinus Surgery (FESS) or Balloon Sinuplasty, are performed under general or local anaesthesia. This ensures patients feel no pain during the surgical procedure.
After the Procedure
Most patients report mild to moderate discomfort post-surgery due to the common use of minimally invasive sinus surgical techniques and advancements in anaesthesia. Minimally invasive surgical techniques typically lead to less pain and faster recovery relative to conventional open surgery.
What Are the Types of Sinus Surgeries?
Here’s a closer look at common sinus surgery options in Singapore:
What Is the Cost of Sinus Surgery in Singapore?
*This table was retrieved in 2024 and the numbers can change over time. The final cost can differ on a case-by-case basis.
Photo credit: Ministry of Health Singapore
The cost for sinus operations in singapore varies based on the type of procedure, the specialist’s expertise, and the facility used. According to the Ministry of Health Singapore’s benchmarks, the basic surgery fee related to nose, sinus, infection, and endoscopic drainage costs thousands of SGD in private clinics.
Many insurers cover medically necessary sinus surgeries, so patients are advised to ask their insurance providers for coverage information.
At Aglow ENT Centre, we understand that not only is providing quality care important, but ensuring patients experience a seamless insurance claim process is critical as well. Thus, our experienced and friendly team is committed to addressing any financial concerns, enabling patients to focus on their recovery with peace of mind.
Our insurance claim & financial counselling services:
- Approximation of Surgery Cost
- Verification Of Insurance Coverage
- Provision of Letter of Guarantee (LOG), Pre-authorisation Certificate and Insurance-approved Medical Reports
You can find our insurance partners here and book a financial counselling session here.
How Do You Choose the Right ENT Specialist in Singapore?
Selecting a qualified ENT specialist is crucial for successful sinus treatment. Factors to consider include:
- Clinical Experience: Studies show that patients experience better outcomes with experienced ENT surgeons.
- Medical Teaching: ENT specialists who teach at prestigious schools like NUS Yong Loo Lin School of Medicine often maintain up-to-date knowledge of the latest surgical techniques.
- Specialised Education: ENT specialists should have undergone the following postgraduate training:
- Master of Medicine (MMed) in Otorhinolaryngology
- Membership of the Royal College of Surgeons (MRCS)
- Fellowship of the Royal College of Surgeons (FRCS) in Otorhinolaryngology
- Medical Affiliations: Specialists associated with reputable facilities such as Mount Elizabeth Orchard have access to advanced medical equipment.
- Consultation Style: A transparent, patient-centred approach can make the consultation process informative and comfortable.
- Paediatric ENT Options: If seeking treatment for a child, look for a paediatric ENT specialist in Singapore with experience in paediatric cases.
Visit Aglow ENT Centre
For tailored advice on sinus surgery, please book an appointment with Aglow ENT Centre to talk to our skilled ENT surgeon, Dr Ker Liang. Dr Ker is a sinus specialist with more than 13 years of experience in the field of Otolaryngology. She has undergone specialised postgraduate training from prestigious universities, such as NUS Graduate Medical School. In particular, she has acquired expert knowledge and skills in endoscopic sinus surgery from her rigorous training courses at Singapore’s National University Hospital (NUH). Her great surgical skills have empowered numerous sinus patients, enabling them to recover well.
Aglow ENT Centre is conveniently located in Singapore’s Mount Elizabeth Hospital (Orchard). We provide comprehensive care for all ages, addressing various ENT conditions with empathy and expertise.
About Dr Ker Liang
Medical Director at Aglow ENT Centre
MBBS (S’pore), MRCS (Edin), MMed (ORL), ACGME-I (ORL)
Dr Ker Liang has over 13 years of experience in the field of Otolaryngology. Dr Ker Liang specialises in treating patients, including children and seniors, with general ENT conditions and has a particular interest in sinus surgery and Laryngology. She underwent fellowship training under Professor Marc Remacle and is well-versed in Laryngological conditions related to the throat, voice, and swallowing. She is a seasoned Laryngologist and has treated many esteemed overseas patients, such as military generals, in her Voice and Swallowing Clinic at NUH.
References
1. Alt JA, Smith TL. Chronic rhinosinusitis and sleep: a contemporary review. Int Forum Allergy Rhinol. 2013;3(11):941-949. doi:10.1002/alr.21217
2. Allergic Rhinitis: Common in Children in Singapore – HealthXchange. Healthxchange. sg. Published 2019. Accessed November 20, 2024. https://www.healthxchange.sg/children/childhood-conditions/allergic-rhinitis-common-children-singapore
3. Young LC, Stow NW, Zhou L, Douglas RG. Efficacy of medical therapy in treatment of chronic rhinosinusitis. Allergy Rhinol (Providence). 2012;3(1):e8-e12. doi:10.2500/ar.2012.3.0027
