MEDIA

Solving Sinusitis

Sinusitis is the infection of sinuses, which are hollow cavities (FILLED WITH AIR IN THE HEALTHY STATE) in the skull

There are four pairs of sinuses: the maxillary sinuses in the cheekbones, the frontal sinuses in the centre of the forehead, the ethmoid sinuses between the eyes at the nasal bridge and the sphenoid sinuses in the bones behind the nasal cavity. Sinuses are ventilated by natural openings into the nasal passages.

The purpose of the sinuses is unknown but probable reasons include: they provide a framework for the teeth to “sit in”, they act as shock absorbers (the anterior wall can collapse when traumatised to prevent direct impact to the brain), they insulate the surrounding organs like the eyeballs, brain and great blood vessels from the drastic changes in air temperature that we breathe, and they lighten the weight of the skull.

Sometimes, however, the sinuses can become infected by bacteria, viruses or fungi. At times, sinusitis can also be caused by dental infections as the roots of the upper teeth are close to the maxillary sinuses. Sinus conditions can be divided in three categories: acute, sub-acute and chronic sinusitis. Acute infections last up to a month, sub-acute infections last two to three months and chronic infections last for longer than three months. Doctors are able to diagnose sinusitis from a detailed history of the patient and examining the nose.

Common symptoms of sinusitis include a blocked or runny nose and pain in the nasal areas. Mucus can also flow back into the throat, causing what is called a post nasal drip. When this happens, the patient will react by coughing. It can also give rise to a sore throat and bad breath.

Patients may also develop a fever in acute infections. If an infection persists, it can cause a middle ear infection as the back of the nose is connected to the ear. In very rare cases, the infection may involve the eye and brain.

Every time you catch a cold or flu, and you have endless amounts of nasal discharge, it is likely to be from infection of the sinuses. Sixty to 70 per cent of patients with a normal flu or upper respiratory tract infection will also have a sinus infection. Such infections take an average of two to weeks to clear up fully spontaneously.

The treatment for sinusitis is usually straightforward and the symptoms are treated directly. For instance, nasal decongestants are given to unblock the nose and sinuses, mucolytics to loosen the mucus and saline spray is given to flush out the nose. In more serious cases, the patient may need a course of antibiotics. However, if an infection persists for longer than three months despite medication, one should do a CT scan to find out why; there may be anatomical problems narrowing the natural openings of the sinuses – the nasal septum may be bent to one side, nasal polyps, swollen lining of nose from allergy, and so forth. Surgery may be needed in such cases.

Generally speaking, sinusitis can be prevented. Make sure you keep your environment clear of dust and mould by cleaning your bedroom and air conditioner filters, staying away from smoky and polluted environments and so forth. Proper hygiene is important as well and if you have allergies, keep them at bay with nasal sprays and medication.

Dr Lau Chee Chong Senior Consultant,
Ear Nose Throat, Head & Neck Surgery

Dr Lau Chee Chong at Mount Elizabeth Centre treats both adults and children. His practice covers all areas diagnostic, surgical and medical of ENT, head and neck practice. The clinic is well-equipped for almost all ENT procedures to be done in-clinic, including NBI (Narrow Band Imaging) video rhinolaryngoscopy, which gives very clear images and is particularly effective in identifying early-stage nose, head and neck cancers.

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