Nose and sinus conditions can cause a blocked or runny nose, facial pressure, changes in smell, postnasal drip and disturbed sleep. Causes include allergies, inflammation, infection and structural narrowing.
The pattern and duration of nose and sinus symptoms can help indicate the cause. They may resemble a common cold, allergy, migraine, or a dental problem.
Persistent nasal congestions and difficulty breathing through the nose may be caused by a nasal obstruction, deviated septum, enlarged turbinates or sinusitis.
Pain or pressure around the cheeks, eyes or forehead can occur with sinusitis, but migraines, dental problems and other conditions can cause similar symptoms.
Thick mucus can occur with viral infections or bacterial sinusitis. Persistent nasal discharge and colour alone do not confirm a bacterial sinus infection or the need for antibiotics.
These symptoms often suggest allergic rhinitis or other allergic reactions. Symptoms triggered by perfume, smoke, temperature changes, or spicy food may indicate vasomotor rhinitis.
Swelling, chronic sinusitis and nasal polyps can affect your sense of smell. Food may seem less flavourful.
Dryness and irritation are common causes, but frequent, heavy, or one-sided bleeding should be evaluated by a healthcare professional.
Nose and sinus problems may result from sinusitis, rhinitis, structural narrowing, injury or tissue growth. For nasal blockage, snoring or recurring sinus concerns in a child, see paediatric ENT care.
Sinusitis
Inflammation of the sinuses that may cause blockage, nasal discharge, facial pressure and reduced smell. Many sinus infections follow viral infections such as the common cold. Some may become a bacterial sinus infection.
Allergic rhinitis
An allergic reaction that commonly causes sneezing, itching, a runny or stuffy nose and congestion.
Vasomotor rhinitis
Non-allergic nasal inflammation triggered by factors such as strong smells, smoke, temperature changes or spicy foods.
Nasal obstruction
Reduced airflow and difficulty breathing through one or both sides of the nose because of inflammation, structural narrowing, or both.
Deviated septum
An off-centre nasal septum that can cause persistent or one-sided blockage.
Turbinate hypertrophy
Enlarged nasal structures that can reduce airflow.
Broken nose
A nasal fracture that may affect appearance, breathing or the position of the septum.
Nasal polyps
Soft, benign growths linked to long-term inflammation that can block the nasal cavity and reduce your sense of smell.
Nosebleeds
Bleeding from the nasal lining, often caused by dryness, irritation, sinusitis, or minor injury.
| Pattern | Duration | What it means |
|---|---|---|
| Acute sinusitis | Less than 4 weeks | Often follows a viral cold and commonly improves with supportive care. |
| Chronic rhinosinusitis | More than 12 weeks | Persistent inflammation that requires clinical assessment and objective confirmation. |
| Recurrent acute sinusitis | 4 or more separate episodes a year | Symptoms clear between episodes, then return as a new acute episode. |
Most sinus infections are viral. A bacterial sinus infection becomes more likely when symptoms persist without improvement for at least 10 days or worsen after initially improving. Coloured discharge can occur with either type and does not, by itself, show that the sinus infection needs antibiotics.
Fungal sinusitis is uncommon. A non-invasive fungal infection can occur in those with otherwise normal immunity, while invasive fungal sinusitis mainly affects people with a weakened immune system and needs urgent specialist care.
To diagnose nose and sinus problems, your ENT doctor will review your symptoms and risk factors, including allergies, asthma, repeated sinus infections, a weakened immune system, cigarette smoke exposure, previous treatments and surgery.
A nasal endoscopy may be used to examine the nasal passages and sinus drainage pathways. A CT scan is not routinely needed for uncomplicated acute sinusitis, but it can help assess chronic sinusitis, recurrent sinus infections, suspected complications, unusual findings or surgical planning. Consider allergy testing when your symptoms suggest an allergic cause.
Managing allergies and avoiding cigarette smoke supports sinus health and may help prevent sinus infections.
Surgery may be considered when your symptoms and examination findings support it, and non-surgical treatment options have not provided adequate control.
Surgery does not replace ongoing inflammation control. After endoscopic sinus surgery, saline rinses and prescribed nasal sprays may still be needed to manage persistent inflammation and symptoms.
Sinus infection complications are rare, but a sinus infection or sinusitis can spread to the eye, surrounding bone or tissues around the brain. Postnasal drips may cause a cough or sore throat, but these symptoms alone do not indicate a serious complication.
Seek urgent care for unusually severe symptoms, high fevers, swellings around the eye or forehead, vision changes, severe headaches, neck stiffness, confusion, neurological symptoms or rapidly worsening illness.
If you have a nosebleed: Sit upright, lean forward and pinch the soft part of your nose continuously for 10 to 15 minutes. Seek urgent care if bleeding continues, is heavy, or causes weakness, dizziness or difficulty breathing.
An ear, nose and throat assessment by an ENT specialist can help distinguish a sinus infection or inflammation from structural causes of persistent nose and sinus symptoms.
At Barrie Tan ENT Head & Neck Surgery, Dr Barrie Tan will assess adults and children at Gleneagles Hospital in Singapore. The consultation may include an examination, a nasal endoscopy and selected tests, followed by an explanation of the findings and the available treatment options.
