Sinus surgery refers to a group of procedures used to improve sinus drainage, relieve blockage, and manage chronic sinus conditions that do not respond to medication. It is typically considered when symptoms persist despite nasal sprays, antibiotics, or other conservative treatments.
Sinus issues often develop gradually, and many people learn to live with the discomfort for months or even years. Over time, blocked passages, facial pressure, and trouble breathing can interfere with daily routines and reduce overall comfort. When repeated flare-ups start to affect sleep, energy levels, or productivity, exploring longer-term solutions becomes important.
Several procedures may be used depending on the underlying cause and severity of the condition. Common options include functional endoscopic sinus surgery, balloon sinuplasty, and procedures to correct structural problems that contribute to poor sinus drainage.
This guide explains the common sinus surgery options available in Singapore, how each procedure works, when surgery may be recommended, and the factors a doctor will consider before advising on the most suitable treatment.
Sinus surgery may be considered when symptoms persist despite appropriate medical treatment and continue to affect breathing, sleep, or daily activities. It may also be discussed when an examination identifies a blockage or underlying condition that could require surgical management.
Common reasons for considering sinus surgery include:
Before recommending sinus surgery, a doctor may carry out a detailed assessment, which can include nasal endoscopy and CT scans. These examinations help identify the cause of the symptoms and determine whether surgery is suitable.
Having one or more of these symptoms does not automatically mean that sinus surgery is required. An ENT specialist will review the diagnosis, previous treatments and examination findings before recommending the most appropriate management approach.
Before recommending sinus surgery, an ENT specialist will assess the cause, location, and extent of the sinus condition. This usually starts with a discussion about the patient’s symptoms, how long they have lasted, and how they affect daily life.
The specialist will also review previous treatments, such as nasal sprays, antibiotics, saline rinses, or allergy medication, and whether these measures provided sufficient relief. Relevant medical factors, including allergies, asthma, and any previous nasal or sinus surgery, may also influence the assessment.
An examination of the nasal passages may then be carried out to look for swelling, discharge, nasal polyps, or structural narrowing. Nasal endoscopy may be used to provide a clearer view of areas that cannot be seen during a standard examination.
Where clinically indicated, a CT scan may be recommended to show the sinuses in greater detail. The images can help identify blocked drainage pathways, inflammation, polyps, or other structural concerns and support surgical planning when necessary.
Functional Endoscopic Sinus Surgery (FESS) is a commonly performed type of sinus surgery in Singapore. It is performed under general anaesthesia and aims to enhance sinus drainage by clearing the natural passages inside the nose.
Step 1: A thin endoscope is inserted through the nostrils. This avoids the need for external cuts. The endoscope contains a light and a camera, allowing the doctor to view the sinus passages on a screen.
Step 2: With the visual guidance from the endoscope, the doctor examines the natural openings of the sinuses to identify swollen tissue, mucus build-up, small bone fragments, or nasal polyps that may be obstructing drainage.
Step 3: Special instruments are guided through the nostrils to remove tissue or obstructions. The goal is to restore airflow and normal drainage while keeping healthy tissue intact.
Step 4: Depending on the patient’s condition, the doctor may address one or several sinus areas in the same procedure.
This form of sinus surgery may be considered for individuals who have:
Balloon sinuplasty is a sinus surgery option for certain conditions where the main issue is the narrowing of the natural sinus openings. The procedure focuses on widening these passages without removing tissue and is often performed in an outpatient or day-surgery setting. Depending on the patient’s needs, it may be carried out under local or general anaesthesia.
Step 1: A small, flexible catheter is inserted through the nostril and gently advanced toward the sinus opening. Imaging or endoscopic guidance helps the doctor confirm the correct placement.
Step 2: Once the catheter reaches the narrowed passage, a balloon attached to its tip is positioned at the point of blockage.
Step 3: The balloon is slowly inflated with controlled pressure. This widens the sinus opening by gently reshaping the surrounding bony structures rather than cutting or removing tissue. After the opening has been widened, the balloon is deflated and removed
Step 4: The doctor may irrigate the area to clear mucus or debris before concluding the procedure.
Balloon sinuplasty may be considered for:
A doctor will assess each patient based on symptoms, scans, and overall health to determine whether balloon sinuplasty is appropriate. This type of sinus surgery is not routinely recommended for conditions involving severe disease or complex structural issues.
Caldwell-Luc surgery is an older technique in sinus surgery that was used before the development of modern endoscopic methods. It was once a standard approach for chronic maxillary sinus issues that did not respond to medication.
Step 1: A small incision is made in the gum above the upper canine or premolar teeth. This approach gives the surgeon access to the bone that forms the front wall of the maxillary sinus.
Step 2: A small window is created in the bone to reach the sinus cavity directly. This allows the surgeon to see and remove inflamed tissue, trapped mucus, or debris inside the sinus.
Step 3: A passage is created between the sinus and the nasal cavity to help improve future drainage. This aims to reduce the likelihood of repeated build-up in the maxillary sinus.
Step 4: Once the cavity has been cleared and the new opening created, the incision inside the gum is closed.
Traditional sinus surgery has become less common because of several considerations:
Septoplasty and turbinate reduction are separate nasal procedures, although they may sometimes be performed together with sinus surgery when more than one issue is contributing to blockage.
Septoplasty addresses a deviated nasal septum that narrows one or both nasal passages. Turbinate reduction reduces enlarged tissue inside the nose to improve airflow. In comparison, functional endoscopic sinus surgery, or FESS, focuses on opening or clearing the sinus drainage pathways.
The recommended procedure, or combination of procedures, depends on the cause and location of the nasal or sinus obstruction. An ENT specialist will assess whether the problem involves the nasal septum, turbinates, sinus openings, or a combination of these structures before recommending treatment.
Before deciding on any form of sinus surgery, it’s important to consider several key factors that influence the treatment plan. Here’s what you should discuss with your doctor when exploring your next steps.
For many patients, the treatment process begins when symptoms continue despite medication such as nasal sprays, antihistamines, or antibiotics. From there, the doctor evaluates whether surgery is appropriate and, if so, which approach may be the most suitable.
Sinus issues can range from mild, occasional discomfort to symptoms that interfere with breathing, sleep, and daily function. Not all cases require surgery. Conditions such as chronic sinusitis, nasal polyps, or structural narrowing respond differently to medical treatment, so the doctor will consider:
These factors help determine whether sinus surgery is necessary and what type of procedure may offer meaningful improvement.
During a consultation, your doctor will perform a nasal endoscopy to examine the sinus openings and nasal passages. CT scans may also be recommended to understand the extent of inflammation, polyps, or blockage.
Your doctor will then use these findings to:
The decision involves weighing the potential benefits of widening or clearing the sinuses against the possible risks of each procedure, ensuring that the decision aligns with the patient’s condition and overall health.
Here are some other personal considerations that should be taken into account:
These factors help guide the treatment plan toward something realistic and manageable for each individual.
In Singapore, the cost of sinus surgery varies depending on the type of procedure, where it is performed, the need for hospitalisation, and other medical requirements.
Some procedures may be eligible for:
Coverage levels differ across insurance plans. Clinics also advise you on estimated fees and on which portions may be claimable.
Before surgery, you may be advised to avoid certain medications, such as blood thinners or specific supplements, to reduce the risk of bleeding. If general anaesthesia is planned, fasting instructions will be provided.
A medical examination or blood tests may also be required to ensure that you are fit for the procedure. Your doctor will also help set realistic expectations for the day of surgery, recovery timelines, and steps to support a smooth healing process.
The type of anaesthesia and setting depend on the procedure. For instance, FESS is typically carried out under general anaesthesia, while balloon sinuplasty may be performed under local anaesthesia in suitable cases.
Surgery duration also varies, ranging from less than an hour to several hours for more complex cases. Most procedures take place in a hospital or a day-surgery facility where nurses and medical staff monitor patients before and after surgery.
Once the procedure is completed, you’ll be moved to a recovery area for monitoring. During this period:
Many patients are discharged on the same day, although some may stay longer depending on their individual condition and the extent of the surgery.
Recovery varies between individuals, but you will likely be advised to:
Proper post-operative care supports healing and helps reduce the risk of infection or early blockage.
Maintaining healthy habits can help you recover more comfortably and lower the likelihood of future sinus issues. These may include:
Most procedures are performed under anaesthesia, so patients do not feel pain during sinus surgery. Mild discomfort, congestion, or pressure may occur afterwards, but pain relief medication is usually prescribed.
Sinus surgery may be considered when ongoing or recurring symptoms do not improve with appropriate medical treatment. An ENT specialist will review your symptoms, previous treatment, and test results before recommending surgery or another approach.
Recovery time depends on the type and extent of the procedure. You may experience temporary congestion, mild discomfort, nasal discharge, or tiredness during the early recovery period. Your ENT specialist will advise when you can resume normal activities.
Sinus surgery can help open drainage pathways and treat areas of blockage, but it may not prevent every symptom from returning. Conditions such as allergies, asthma, nasal polyps, or chronic inflammation still require ongoing management.
MediSave may be used for eligible inpatient or day surgery expenses in Singapore, subject to the procedure performed and the applicable withdrawal limits. Patients should check with the clinic or hospital for an estimate of their MediSave claim and remaining out-of-pocket costs before treatment.
Sinus problems can affect many aspects of daily life, from breathing and comfort to sleep and productivity. Understanding the different types of sinus surgery, including options like FESS, balloon sinuplasty, and older traditional methods, can help you navigate your choices with more confidence.
If medication is no longer helping or your symptoms are affecting your quality of life, speak with Dr Jenica Yong, an ENT specialist in Singapore. She provides care for both adults and children, and can discuss options ranging from sinus procedures to sleep apnea surgery. During the consultation, you will have the chance to review your concerns and decide on a care plan that feels right for you.
Book an appointment today.
