Sinusitis is an inflammatory condition characterised by facial pain and pressure, nasal congestion, thick nasal discharge, and a reduced sense of smell, typically caused by viral infections or allergic rhinitis. Sinusitis treatment includes rest, fluids, saline rinses, pain relievers, and decongestants. Oral antibiotics may be required for bacterial sinusitis cases. If you have severe symptoms, persistent sinusitis, or your symptoms worsen after a week, consult an ENT specialist.
Your sinuses are four paired, air-filled spaces (cavities) in the skull, like small caves, lined with tissue:
These cavities connect to your nose through the nasal passages, which are small, narrow tunnels. Their jobs include warming and moistening the air you breathe, protecting your face, and helping your voice sound the way it does.
If these small tunnels become blocked, the mucus produced cannot drain. This causes a stuffy nose, facial pain, and thick mucus, all signs of a sinus infection. However, not all cases of sinusitis are the same. Some are caused by a common cold (viral sinusitis) or just swelling (sinus inflammation). These changes affect how our ENT specialist decides to treat your sinusitis.
Symptoms of sinusitis due to blocked drainage typically include facial pressure, nasal obstruction, and postnasal drip. These sinusitis symptoms vary and often worsen with bending.
Acute sinusitis cases may also cause general malaise, including tiredness, low-grade fever, and upper-jaw tooth infections.
Sinusitis symptoms often overlap with migraine, dental, reflux, or allergic issues, making the pattern key. In Singapore, distinguishing a true sinus infection from persistent rhinitis (due to air conditioning, weather, haze, etc.) is crucial. They include:
Seek medical attention for the following symptoms: high fever (>40°C/103°F), severe, stiff neck headache, confusion, vision changes (double, blurred, or loss), severe eye swelling with severe pain or difficulty breathing when moving the eye, severe facial swelling, seizures, persistent vomiting or dehydration, or unusual drowsiness and unresponsiveness, especially in a child.
Nasal polyps are soft, non-cancerous lumps caused by swelling inside your nose and sinuses. They can obstruct the nose, impair olfaction, and often lead to recurrent sinus infections that are difficult to resolve.
Sinusitis may stem from less common causes, such as fungal sinusitis (especially invasive fungal sinusitis, which requires specialised treatment), a weakened immune system, aspirin-exacerbated respiratory disease, or ciliary dysfunction.
See an ENT specialist if your sinusitis is persistent, recurrent, severe, or affects sleep and your daily life despite initial treatment. While acute sinusitis cases often resolve with time and supportive care, these signs warrant a targeted plan of care:
To diagnose sinusitis, we check your symptoms and conduct a nasal examination. Further tests are used only if they will alter the subsequent treatment.
Step 1: Relevant history
Duration, recurrence, primary symptom, olfactory changes, allergies or asthma, sleep impairment, dental symptoms, and response to prior antibiotics.
Step 2: ENT examination
Checks for nasal swelling, discharge, polyps, septal deviation, and ongoing inflammation, and helps rule out dental or headache causes of similar symptoms.
Step 3: Nasal endoscopy if needed
A closer look at the nasal cavity and sinus drainage areas to identify polyps, pus, narrowing, or bleeding, and to guide cultures when appropriate.
Step 4: Targeted tests when indicated
If you’re wondering how to cure sinusitis permanently, there are several sinus infection treatments that reduce swelling and improve drainage. Non-surgical methods vary depending on whether the case is acute, recurrent, or chronic, based on symptom duration.
Type | Duration | Characteristics |
Acute Sinusitis | Less than 4 weeks | Usually viral, tends to improve with supportive care |
Subacute Sinusitis | 4-12 weeks | Symptoms persist beyond the acute phase |
Chronic Sinusitis | 12+ weeks | Ongoing sinus inflammation, sometimes with nasal polyps |
Recurrent Acute Sinusitis | 4+ episodes/year | Repeated acute flare-ups with symptom-free gaps in between |
To relieve additional symptoms, such as pain and pressure, and to improve drainage, both over-the-counter medications and alternative treatments can be used. These treatments include acupressure, acupuncture and facial massages.
Prevent sinusitis by maintaining clear nasal passages, minimising triggers and promoting drainage. Use sterile saline rinses after exposure to dust or haze, and maintain these devices in a clean state. Manage allergies by avoiding nasal steroids and consider allergy testing for persistent symptoms.
During periods of high haze, use an air purifier, keep indoor humidity between 30% and 50%, and avoid exposure to smoke and fumes. Maintain adequate hydration, ensure adequate sleep, and manage asthma, rhinitis, and gastroesophageal reflux disease. For recurring issues, consult an ENT to discuss long-term options, such as immunotherapy or correction of anatomical abnormalities, to prevent recurrence.
Sinusitis Specialist Care
See an ENT (Ear, Nose, and Throat) specialist for sinusitis if symptoms persist for more than 10–12 days without improvement, if infections are recurring (4+ times a year), or if you experience severe symptoms like high fever, vision changes, or severe headaches. Chronic sinusitis lasting over 12 weeks also warrants specialist care.
Sinus surgery is recommended when persistent symptoms persist despite other suitable non-invasive methods. It is not a quick fix. The best results require a clear surgical indication and a robust post-operative plan. Sinus operation costs in Singapore vary with procedure complexity.
FESS uses small endoscopes to open natural sinus drainage pathways and remove obstructive tissue lining the sinuses, such as polyps. It restores ventilation, allowing topical treatments (sprays/rinses) to be effective. For many with chronic sinusitis, this is the most effective procedure when conservative treatment fails.
Correcting a deviated septum or enlarged turbinates can significantly improve airflow when these anatomical features substantially contribute to the blockage. This correction also facilitates CPAP use in individuals with sleep-disordered breathing and often becomes necessary when persistent nasal obstruction drives sinus symptoms.
Most sinus procedures are generally safe when indicated, but all treatments have potential side effects.
Sinusitis itself is not usually contagious, but the viral cold that triggers it can be.
No. Mucus colour can change during viral infections too, so colour alone does not determine whether antibiotics are needed.
Nasal inflammation can affect pressure regulation, leading to ear fullness or light-headedness. However, persistent dizziness should be assessed for other causes.
Rhinitis is the inflammation of the nasal lining, while sinusitis involves the sinus cavities and their drainage pathways. They often occur together, which is why effective treatment commonly targets both.
If symptoms last more than 10 days without improvement, recur frequently, or persist beyond 12 weeks, it is sensible to see an ENT specialist.
Not always. CT is most useful for chronic or recurrent disease, suspected complications, or when surgery is being considered.
Surgery can significantly reduce symptoms and flare frequency, but long-term success usually depends on ongoing control of inflammation, especially in allergic or polyp-related disease.
Consistent saline rinses, proper use of nasal sprays, allergy management, and avoidance of irritants such as smoke can reduce recurrence.
Flying during acute sinusitis can be extremely painful due to changes in air pressure. If you must fly, use a decongestant spray before the flight, chew gum during ascent and descent, and consider postponing the flight if symptoms are severe.
For chronic sinusitis or post-surgical care: 1-2 times daily. During acute flare-ups: Up to 3-4 times daily. After exposure to dust or haze, once daily for prevention. Always use sterile water.
Most integrated shield plans cover medically necessary sinus surgery. Medisave can be used within approved limits. Check with your insurer for specific coverage and obtain pre-authorisation.
Yes. Sinus pressure or infection can cause upper tooth pain, often affecting several teeth on one side rather than a single tooth.
MBBS, MRCS (Edinburgh), MMed (Otorhinolaryngology), FAMS
Dr Barrie Tan is an ENT specialist at Gleneagles Hospital, Singapore, with more than 20 years of clinical and surgical experience. He previously served as Head of ENT and Director of the Centre for Hearing and Ear Implants at Singapore General Hospital. The information provided is not intended as medical advice. More about our medical experts.
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