Sinusitis

Sinusitis

Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses are hollow air spaces within the bones surrounding the nose. They produce mucus, which drains into the nose.

Sinuses are normal air-filled spaces within the face. There are 4 big groups of sinuses and these can be infected with pus resulting in sinusitis.

Sinusitis are infections of the sinuses. Sinuses are air filled spaces within the face. Infections can occur acutely (within 3 months) or it can be chronic sinusitis where patients have blocked nose and runny nose for more than 3 months. In severe sinusitis, it can result in a loss of smell(Anosmia).

Sinusitis if severe can also result in headaches or eye pain. This is because the sinuses are located around the eyes. The sinuses are filled with pus and the pressure within the sinuses results in pain.


Picture of the 4 big groups of sinuses surrounding the nose.

Other symptoms evaluated includes

  • Blocked nose
  • Runny nose & sneezing
  • Coloured mucus (nasal discharge)
  • Facial pain
  • Sinus headaches
  • Postnasal drip
  • Reduced sense of smell (Hyposmia or Anosmia)
  • Nose bleed (Epistaxis)

Evaluation involves a thorough examination by Dr Dennis Chua. A gentle nasoendoscopy is done to assess her condition. You may or may not require a CT scan of the sinus for further assessment.

A thorough nasoendoscopy can reveal mucopus with postnasal drip. This resulted in the patient experiencing sore throat and chronic cough with minimal nasal symptoms since the pus was irritating the throat more than the nose.

Treatment usually involves nasal wash with nasal sprays. Antibiotics may be needed. If the infection persists after broad spectrum antibtiotics, it may be needed to obtain a swab of the pus from the sinuses for culture to see that type of organisms that is growing to have a targeted antibiotic therapy.

Endoscopic Picture of a swab of the pus from the sinuses. This is to find out the organisms causing the infection and to help determine the antibiotic therapy suitable to treat this infection.

In severe cases, minimally invasive techniques eg balloon sinuplasty can be used to wash out the pus out of the sinuses. There are no cuts necessary on the face for this operation. Everything is performed endoscopically within the nose.

Picture of endoscopic balloon sinuplasty. The device is used to access the opening of the blocked sinuses and the balloon is inflated to “unblock” the sinuses for aeration.

Occasionally for patients who have failed maximal medical therapy, a FESS (Functional endoscopic sinus surgery) may be necessary to thoroughly wash out the sinuses. If nasal polyps are detected at the same time, these can be removed and sent for histology to exclude a tumor. This is usually a day surgery procedure with minimal discomfort to the patient.

For complex nose and sinus diseases that Dr Dennis Chua is accredited to do: 
Image Guidance System (IGS) can be used during surgery. The sinuses are located near critical structures like the eye and the brain. Accuracy and precision during surgery is necessary to ensure complete removal of diseased tissues and minimize the chance of injury to the critical structures. Having IGS is akin to driving with GPS (navigation), it allows the use of sinus equipment to treat each of the diseased sinuses accurately.

  • There can be some blood stained mucus discharge from the nose in the first 24 hours after surgery. This will lessen after that.
  • You may experience some nasal congestion due to the dressings Dr Dennis Chua applies within the nose and sinus to expedite wound healing. This will be removed the following day.
  • The results of any histology sent (for example for polyps) will take 3 working days for the final results to be out.
  • You may feel slightly giddy due to the anaesthetic effects. Be careful when you move about.
  • Do not agitate the wound in the nose and sinuses by frequent throat clearing or trying to clear the nose. This can result in bleeding.
  • Be gentle around the nose and oral cavity. If you find a lot of mucus or phlegm in the throat, you can swallow it.
  • If you feel the urge to sneeze, do so with the mouth open. Sneezing results in airspeeds of up 150Kmh and can traumatise the wounds in the nose and sinuses.
  • Avoid straining or heavy lifting in the first 2 weeks after the operation. Intense physical exertion are not recommended.

Ask Us if you have any question?

Feel free to drop us a message if you have concerns or symptoms pertaining to sinusitis.