The most common ENT sinus problems and how to deal with them

asian woman blowing her nose

As an ENT specialist, on a daily basis, I see many patients who suffer from nose related conditions. Nose related conditions, especially chronic ones, can be extremely difficult for patients and it can result in a reduction of quality of life as well as a negative effect on the patient’s ability to function on a day-to-day basis. Many of these conditions are acute and last only for a short time, but chronic sinus problems are far more common than you think.

Many over-the-counter medicines and treatments treat nose or sinus-related problems on a symptomatic level, which allows the body time to rest and cure the condition naturally using antibodies produced by the immune system. However, for more chronic ENT conditions such as chronic sinusitis or rhinitis, surgery may be needed in order to fully eliminate these conditions once and for all.

Sinusitis

Sinusitis happens when the tissue that lines our sinuses becomes swollen and inflamed, commonly due to a viral or bacterial infection. There are many common, everyday conditions that can block our sinuses up! Some of these conditions include:

  • Common cold
  • Nasal polyps
  • Arising due to a deviated septum

This is an extremely common condition! A large majority of us get sinusitis at least once or twice a year. There is a myriad of factors that can cause sinusitis, including exposure to cigarette smoke or a weak immune system. Symptoms of sinusitis include pain or pressure in the nasal area, your nose being completely blocked, inability to discern smells, a runny nose and a chesty cough, sometimes with phlegm.

For more acute and serious sinusitis infections, this may even result in you developing a fever or halitosis (bad breath) as your upper respiratory tract is compromised. If your nasal discharge has a distinct green or yellow colour, it is likely to be a bacterial sinus infection. As the ear, nose and throat areas are all connected, some patients report headaches and ear pain as well whilst suffering from acute sinusitis symptoms.

Effective medication for Sinusitis

Most of the time, taking a decongestant or a nasal spray can help to relieve symptoms. If it is determined that the cause of your sinusitis is bacterial, it is likely that your doctor will prescribe antibiotics to you which will be around a 2-week course.

asian woman with sinus problems blowing her nose

Allergic Rhinitis

Suffering from allergies? You’re not alone! Allergic Rhinitis (AR) actually is an extremely common ENT condition in Singapore. It affects around 15% of our entire population, which is roughly one in 7 people! Allergic Rhinitis is characterized by violent sneezing, watery eyes, itching on the nose and a blocked and runny nose. Allergic rhinitis is commonly triggered by foreign substances such as pet dander, dust mites, pollen and other pathogens.

How does this happen? All of us naturally have an immune system which is designed to produce chemicals that affect inflammation. By doing this, the body protects against the entry of foreign bodies. Once our sensitive ear, nose and throat tissue comes into contact with these foreign bodies, the body greatly increases the amount of chemicals that cause inflammation, which leads to these symptoms.

Dealing with allergic rhinitis

As allergic rhinitis is primarily a condition caused by inflammation of tissue, it only makes sense that anti-histamines, which reduce inflammation and itching, are used to combat the symptoms. These can also be combined with decongestants that open up the nasal airways in order to relieve pressure and allow you to breathe better.

There is also the option of steroidal nasal sprays as well as non-steroidal nasal sprays. For more moderate symptoms, you can consider using steroidal nasal sprays for up to 2 weeks continuously. Remember, steroids are a serious medication and you should not use them without a proper prescription or guidance from your doctor.

For those of you with red and watery eyes, there are anti-histamine eyedrops which can provide effective and swift relief from those red and itching eyes. Finally, for those who are suffering from blockages in their nasal passages, a saline nasal wash can be very effective in clearing up the nasal passage, making it far easier for you to breathe.

Of course, if you’ve been diagnosed with allergic rhinitis, avoid places where you might be exposed to potentially triggering allergens. This is the best way to avoid an allergic reaction and save yourself from having to endure the discomfort of allergic rhinitis symptoms.

asian woman in bed trying to fall asleep

Obstructive Sleep Apnea

Sleep apnea comes in many different shapes and sizes. The most common one, obstructive sleep apnea, occurs when throat muscles are too relaxed and cause a host of symptoms. Loud snoring, your breath being cut off while sleeping and disturbed sleep are all indicative of obstructive sleep apnea.

When your throat muscles become too relaxed, your airway that you use to take in oxygen becomes overly narrow. When this happens, you are unable to take in the air that you need, which causes your brain to send signals to rouse you from your sleep so that you can gasp and take in more air. Needless to say, this can have an extremely detrimental effect on the quality of your sleep, which might trigger extreme tiredness during the day and greatly reduce your ability to function properly. Deep REM sleep is needed for proper rest, and patients who suffer from obstructive sleep apnea are unlikely to have long uninterrupted segments of deep REM sleep.

How do I deal with obstructive sleep apnea?

Firstly, we have to understand who is susceptible to obstructive sleep apnea. Most commonly, obstructive sleep apnea affects obese or overweight people. This is because fat tissue that has accumulated around airways can vastly narrow it. Smokers are also prone to get it due to cigarette smoke causing the tissue in the upper airway to retain fluid. Thus, first line lifestyle adaptations like losing weight, cessation of smoking and alcohol avoidance are all recommended for those struggling with obstructive sleep apnea.

Ingestion of any central nervous system depressants such as alcohol, benzodiazepines or other hypnotic medication will cause the throat muscles to relax and thus worsen obstructive sleep apnea.

The best treatment for obstructive sleep apnea is a CPAP machine. The CPAP machine fits a mask over your nose and mouth during sleep and gently uses air pressure to keep your airways open during sleep. This is an effective, non-surgical method to deal with obstructive sleep apnea that will greatly improve the quality of your sleep and overall life.