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Chronic Sinusitis

1. What is the condition about?

Chronic sinusitis is a persistent inflammation of the sinus cavities that lasts for 12 weeks or longer, despite medical treatment. This condition can cause a range of uncomfortable symptoms, significantly impacting an individual’s quality of life. Understanding its causes, effective management, and treatment options is crucial for those affected.

2. What are the causes?

Common Causes of Chronic Sinusitis:

  • Infections: Chronic sinusitis can result from recurrent or untreated acute sinus infections, often triggered by bacteria or viruses.
  • Allergies: Allergic reactions to pollen, dust, pet dander, or mold can lead to chronic inflammation of the nasal passages and sinuses.
  • Nasal Polyps: Noncancerous growths in the nasal and sinus passages can obstruct airflow and contribute to chronic sinusitis.
  • Deviated Septum: A deviated septum, a shift in the nasal septum’s position, can disrupt normal drainage and airflow, leading to sinusitis.
  • Environmental Irritants: Exposure to pollutants, smoke, or irritants can exacerbate chronic sinusitis symptoms.
  • Immune System Disorders: Certain immune system conditions can increase susceptibility to chronic sinusitis.

Identifying the underlying cause of chronic sinusitis is crucial for determining the most appropriate treatment plan.

3. How common is the condition?

Chronic sinusitis is a prevalent condition that affects a substantial portion of the population. Its prevalence can vary based on geographic location, environmental factors, and individual risk factors.

Global Prevalence:

  • Chronic sinusitis is a common reason for seeking medical attention and is a frequent diagnosis in ENT clinics worldwide.
  • In Singapore, the prevalence of chronic sinusitis is notable, with environmental factors like high humidity and allergen exposure contributing to the condition.

Risk Factors: Certain risk factors, such as a history of allergies, previous sinus infections, or structural abnormalities, may increase an individual’s susceptibility to chronic sinusitis.

4. What can an ENT Specialist do for you?

Consulting with an Ear, Nose, and Throat (ENT) specialist is essential for accurate diagnosis, effective management, and relief from chronic sinusitis.

The Role of an ENT Specialist:

Accurate Diagnosis

ENT specialists have the expertise and specialized equipment to accurately diagnose chronic sinusitis, identify its underlying causes, and assess the extent of inflammation.

Treatment Planning

After a thorough evaluation, an ENT specialist can develop a personalized treatment plan tailored to the patient’s specific condition and needs. This may include medications, lifestyle modifications, or surgical options.

Minimally Invasive Procedures

ENT specialists are trained in performing minimally invasive procedures such as Functional Endoscopic Sinus Surgery (FESS) to alleviate chronic sinusitis symptoms by addressing structural issues, polyps, or obstructions.

Long-Term Care

ENT specialists provide ongoing care and monitoring to ensure the best possible outcomes. They can also address any complications or recurrent sinusitis effectively.

Consulting with an ENT specialist ensures that patients receive the most appropriate and advanced care for their chronic sinusitis, potentially leading to improved quality of life and symptom relief.

5. How can the condition be treated?

The treatment of chronic sinusitis depends on its underlying cause, severity, and duration. Various treatment options are available, ranging from conservative approaches to surgical interventions.

Treatment Options for Chronic Sinusitis:


For mild to moderate cases, medications such as antibiotics (for bacterial infections), corticosteroids (for inflammation), antihistamines (for allergies), and decongestants (to relieve congestion) may provide relief.

Lifestyle Modifications

Lifestyle changes, such as allergen avoidance, using saline nasal rinses, and maintaining good nasal hygiene, can help alleviate symptoms and prevent recurrence.

Minimally Invasive Procedures

Surgical options such as Functional Endoscopic Sinus Surgery (FESS) can be performed by ENT specialists to address structural issues, remove nasal polyps, and improve sinus drainage.

ballon sinuplasty
Balloon Sinuplasty

In cases where sinus blockages are contributing to chronic sinusitis, Balloon Sinuplasty may be recommended to open blocked sinus passages and restore normal airflow.

Traditional Sinus Surgery

In severe cases, traditional sinus surgery may be necessary to address specific structural abnormalities or recurrent infections.

The choice of treatment, whether conservative or surgical, should be made in consultation with an ENT specialist after a thorough evaluation of the patient’s condition and individual needs.

6. Guidelines for Surgery

When conservative treatments do not effectively alleviate chronic sinusitis symptoms or when structural issues, such as nasal polyps or blocked sinus passages, are identified, surgical intervention may be considered. Here are important guidelines to consider when contemplating surgery for chronic sinusitis:

Pre-operative Preparations:

  • Consultation: Schedule a thorough consultation with an ENT specialist to discuss your symptoms, medical history, and the need for surgery.
  • Diagnostic Tests: Your specialist may recommend imaging tests, such as CT scans or endoscopy, to assess the extent of sinus involvement and plan the surgical approach.
  • Medical Evaluation: Complete any necessary medical evaluations and provide a list of current medications, allergies, and medical conditions.
  • Anesthesia: Discuss anesthesia options and potential risks with your surgical team.
  • Fasting: Follow fasting instructions provided by your healthcare providers to prepare for surgery.

The Surgical Procedure:

  • Anesthesia: Depending on the type of surgery and your individual needs, you may undergo either local or general anesthesia.
  • Surgical Techniques: The surgeon will use specialized techniques, often minimally invasive, to address the specific issues contributing to chronic sinusitis. Functional Endoscopic Sinus Surgery (FESS) is a common procedure to open blocked sinus passages, remove polyps, and improve drainage.
  • Recovery: After the procedure, you’ll be monitored in a recovery area. Most sinus surgeries are performed on an outpatient basis, allowing you to return home the same day.

7. Evaluation & Follow Up for Treatment

Following sinus surgery for chronic sinusitis, thorough evaluation and follow-up care are essential for a successful recovery and optimal results.

Post-operative Care
  • Home Recovery: You will receive specific instructions for post-operative care, including wound care, pain management, and any necessary medications.
  • Follow-up Appointments: Attend all scheduled follow-up appointments with your ENT specialist. During these visits, the surgeon will assess your healing progress, address any concerns, and remove any nasal packing or sutures if used.
  • Monitoring: Your specialist will monitor your condition to ensure that the surgical goals have been achieved and that you are experiencing improved sinus health with reduced symptoms of chronic sinusitis.
Long-term Care
  • Nasal Hygiene: Continue practicing good nasal hygiene as advised by your ENT specialist to maintain optimal sinus health.
  • Allergy Management: If allergies were a contributing factor to chronic sinusitis, follow your specialist’s recommendations for allergy management to prevent recurrence.
  • Lifestyle Modifications: Make necessary lifestyle changes, such as avoiding irritants or allergens, using a humidifier, and practicing good nasal hygiene, to support ongoing sinus health.

8. Risks of Surgery

While surgical interventions for chronic sinusitis are generally safe and effective, it’s essential to be aware of potential risks and complications associated with any surgical procedure.

Possible Risks and Complications:

  • Bleeding: Some bleeding is common during and after surgery but is typically temporary and manageable.
  • Infection: Infections are rare but possible; prompt treatment is essential to prevent complications.
  • Scarring: Surgical procedures may result in minimal scarring, but this is usually inconspicuous.
  • Changes in Sensation: Some individuals may experience temporary changes in sensation, such as numbness or altered sense of smell, which typically improve over time.
  • Recurrence: In some cases, chronic sinusitis symptoms may recur after surgery, although they are usually less severe.

Discuss any concerns or questions regarding potential risks with your ENT specialist before undergoing surgery.

9. Alternatives to Surgery

In cases where surgery may not be the first-line treatment or may not be suitable for certain individuals, alternatives to surgery should be considered based on the specific cause and severity of chronic sinusitis.

Alternative Treatment Options:

  • Medications: Medications such as corticosteroids, antibiotics (for bacterial infections), antihistamines (for allergies), and decongestants may provide relief from chronic sinusitis symptoms.
  • Lifestyle Modifications: Lifestyle changes, such as avoiding irritants or allergens, using saline nasal rinses, and maintaining good nasal hygiene, can help prevent recurrent symptoms.
  • Balloon Sinuplasty: In cases where sinus blockages are contributing to chronic sinusitis, Balloon Sinuplasty may be recommended to open blocked sinus passages and restore normal airflow.

The choice of treatment, whether surgical or non-surgical, should be made in consultation with an ENT specialist after a comprehensive evaluation of your condition and individual needs. Your specialist will help determine the most appropriate and effective treatment plan to provide long-lasting relief from chronic sinusitis.