Haze and sinus problems

Haze and sinus problems

Question: Does the current bad haze problem in Singapore affect my sinus problem? What can I do about it?

Answer: I always see more of my patients with chronic sinusitis come in with exacerbation of symptoms during periods with bad haze. This includes those who have had surgery and have been very stable for a long time. I suppose it does not help that their sinuses have been opened surgically to facilitate drainage of the sinuses and are therefore now more exposed to the effects of the haze.

The haze basically is a non-specific irritant affecting the lining of our nose and sinuses. For those with ‘sinus‘ which is really nasal allergy, the non-specific irritation affects those with poorly controlled allergy much in the same way as temperature change or strong smells and spices. For these, good control of their underlying allergy should limit the effects as it basically renders the nose less sensitive to non-specific irritants. For those on regular nasal steroids but still experiencing worsening of symptoms, spraying twice a day instead of once a day may help.

For those with true sinus infections without surgery but experiencing acute symptoms, EPOS (European) guidelines suggest that using nasal steroids in the first week without resorting immediately to antibiotics may be sufficient. This is because it is usually not a bacterial infection in the beginning. Of course, if symptoms persist, antibiotics may be necessary but is best guided by culture and sensitivity tests based on what bacteria are present and what antibiotics they are responding to in the lab.

For those who have had surgery, prevention is probably the best cure. Minimising exposure to haze is important since the sinus openings will be unusually large. If symptoms develop, the large openings however mean that nasal douching may be enough without having to resort to medication. On the other hand, if polyps develop despite the large openings, oral steroids may be necessary to settle the inflammation as such patients often have hyper-reactive airways and unusually strong immunological responses.

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