Sinus Surgery


What is Sinus Surgery?

Sinus surgery is a minimal access (keyhole) surgical treatment option in Singapore for conditions that affect the sinuses, such as acute or chronic sinusitis, and for the removal of nasal polyps. It may also include removing sinus tissue that has become infected. Typically, people undergo sinus surgery due to severe and chronic sinus problems where medication, including nasal rinses or other medical treatments fail to solve the problem. 

What are Sinuses? 

Surrounding the nasal passages are air filled spaces within the bone of our faces. These are known as paranasal sinuses. They are situated inside the cheekbones and forehead. The sinuses are normally lined by thin mucosa. Occasionally, when the sinuses become inflamed or infected, the mucosal lining becomes thicker, and the sinuses may fill with thick mucus and infected materia. In this situation, the person is said to have developed Sinusitis or sinus infections. In this situation, the sinus linings become swollen and blocked, trapping mucus and impacting airflow.

The sinuses are normally air-filled spaces  situated inside of our cheekbones and forehead.

We generally divide sinusitis into acute and chronic subtypes. The common causes of sinusitis include:

  • Upper respiratory tract infections (URTI) which are usually viral in origin, and later cause secondary bacterial sinusitis 
  • Nose allergies
  • Smoking or exposure to secondhand smoke
  • Structural issues in the nasal passages, such as deviated septum
  • Nasal polyps 

While sinusitis may be a temporary symptom following the common cold, for those with structural issues in the nasal passages such as deviated septum, or nasal polyps, or bone spurs, it is often can be recurring or even a permanent problem that may only resolve with surgery. For those with nose allergies or a weakened immune system, sinus infections may happen more often. Sinus surgery can also treat those who suffer from sleep apnoea by widening the nasal airways to facilitate better airflow and breathing. 

Those who experience sinusitis often have the following symptoms:

  • Difficulty breathing
  • Stuffy or runny nose
  • Bad breath
  • Cough
  • Discharge from the nose, or Post-nasal drip
  • Sore throat
  • Facial pain and pressure, or forehead pain 
  • Fever
  • Reduced or loss of sense of smell
Sinusitis can cause a number of unpleasant symptoms, from facial pain and stuffy nose.

How does Sinus Surgery work?

There are a few types of sinus surgery, the two most common being:

  • Functional endoscopic sinus surgery (FESS): minimally invasive surgery involving the use of endoscopes (thin tubes with lights on the end connected to a camera) to widen drainage passages in the nose, as well as to remove infected bone, polyps, or infected tissue. 
endoscopic sinus surgery
Endoscopic sinus surgery is used to widen drainage passages and remove bone spurs, polyps, and infected tissues.
  • Balloon sinuplasty: minimally invasive procedure involving the use of an endoscope and catheter to insert a small balloon into the nose to widen the passages in the nose and sinuses. 
balloon sinuplasty
Balloon sinuplasty is a minimally invasive procedure used to widen the passages of the nose and sinuses.

It is important to note that endoscopic sinus surgery will improve nasal breathing and is effective at treating sinusitis, but will still require continuation with medication and nasal rinses,to optimise one’s sinus health. The ENT specialist will explain more to you regarding this during your consultation. Prior to sinus surgery, you may need to undergo a CT scan of the sinuses to identify which of the sinuses are involved, and your ENT specialist will discuss these scans with you and explain what will be done during the sinus surgery. 

CT scan sinuses
A CT scan of the sinuses is performed prior to sinus surgery. This is to ensure all the diseased sinuses are treated. The CT scan is also used to provide Image-guidance during surgery to optimise the safety of the surgery.

 Benefits of Sinus Surgery in Singapore

  • Effective treatment for sinusitis, where medications fail to resolve symptoms. 
  • Removes polyps or bone spurs
  • Widens passageways in the nose
  • Improves airflow in the sinuses

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What conditions can Sinus Surgery treat?

Sinus surgery can be used to treat the following conditions:

  • Acute Sinusitis
  • Chronic sinusitis
  • Nasal polyps
  • Can be done simultaneously to also correct structural issues such as deviated septum 
  • Sleep apnea (requires evaluation to diagnose and treat this at the same time) 

What results can I expect? 

Remarkably, due to the minimal access (keyhole) nature of this surgery where there are no surgical cuts externally, there is very minimal discomfort or pain. The ENT Specialist will provide you with medications to be used in the days and weeks following surgery to maintain the patency of the nasal passages. The doctor will also review you in the clinic after the surgery to clean the nose further, to allow more rapid recovery. You will be able to breathe better. 

Chronic sinusitis can impact daily life and lead to sinus infections.

How many treatment sessions are needed? 

In general, only one surgery is required to treat sinus issues such as sinusitis and sleep apnoea. Sinus surgery is usually done in one to two hours, depending on the complexity of the case. You may need to spend one night in the hospital to recover. 

If you are experiencing acute or chronic sinus problems, contact us to find out if endoscopic minimal access sinus surgery is a suitable treatment option for you. 

Frequently asked questions

Is sinus surgery painful?

General anaesthesia is administered before the surgery commences. On waking, there is also only minimal discomfort experienced. It is not a painful surgery. 

Is sinus surgery a major surgery?

Endoscopic sinus surgery is a minimal access procedure to treat problems in the sinuses, as it is conducted through an endoscope instead of cutting through the nose. This is a routine procedure, with very good success rates, and minimal risk. 

Why would you have sinus surgery?

You might need surgery if you have acute or chronic sinusitis that does not improve with medication. Sinus surgery may also be necessary for the treatment of polyps, deviated septum, or other issues that are causing mucus blockages and impairing airflow. All these can be treated in one sitting. 

Allergy & Sinus ENT Specialist Centre
Head & Neck Surgery Singapore

Dr Soma Subramaniam
Consultant ENT Specialist and Surgeon
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