Nasal & Sinus Treatment
25+ YEARS ENT EXPERIENCE
DR VYAS PRASAD
FRCS (ORL-HNS)
senior consultant
Specialist ENT care for chronic blocked nose, sinus infections and facial pressure in adults and children.
Thorough assessment, advanced imaging when needed, and tailored medical or surgical treatment to help you breathe and live comfortably.Nasal and sinus problems are among the most common reasons people seek ENT assessment. A persistently blocked nose, recurring sinus infections, loss of smell, or constant post-nasal drip can significantly affect sleep, concentration, and quality of life — yet many patients live with these symptoms for years before seeking specialist help.
Dr Vyas Prasad provides specialist assessment and treatment of the full range of nasal and sinus conditions. Evaluation is minimally invasive, typically involving in-clinic nasal endoscopy, and treatment is always guided by the underlying cause rather than a one-size-fits-all approach.
Persistent blocked or stuffy nose
Persistent headaches
Common symptoms of nose and sinus problems
If you are experiencing any of these persistent issues, a specialist ENT review can help identify the root cause beyond temporary relief.
Facial pain or pressure
Bad breath (Halitosis)
Thick nasal discharge or post-nasal drip
Recurrent sinus infections
What can cause a blocked nose or sinus issues?
A persistent sensation of blockage or pressure can stem from several underlying conditions. Accurate diagnosis by an ENT specialist is essential for tailoring a treatment plan that addresses the specific anatomical or inflammatory cause of your symptoms.
Allergic rhinitis (nose allergy)
Structural issues such as a deviated septum
Enlarged turbinates
Nasal polyps
Chronic sinusitis
Adenoid enlargement in children
Acute sinus infections
Less common causes such as tumours or other growths
When should you see an ENT specialist?
Nose & Sinus Health
Persistent symptoms often require anatomical assessment to find the root cause. You should consider a specialist review if you experience any of the following:
• Symptoms of blocked nose or sinus pressure lasting more than 3 months
• Frequent or recurrent sinus infections that impact daily life
• Severe facial pain, pressure, or persistent localized headaches
• Blocked nose that does not respond to usual medications
• Significantly reduced or altered sense of smell (hyposmia)
• Any worrying lumps, growths, or structural changes
My approach to nose and sinus care
I believe that every patient’s journey to better breathing starts with a careful and detailed history. Understanding how your symptoms affect your daily life allows me to tailor my assessment and treatment plan specifically to your needs, ensuring we address your primary concerns from the first consultation.
In my clinic, I perform a thorough examination of the nose and sinuses, often utilizing advanced nasal endoscopy for a precise view. When indicated, I order specialized imaging such as CT scans to understand the underlying structural anatomy and extent of any sinus disease with absolute accuracy.
My focus is on identifying the root cause of your blockage—be it allergic rhinitis, a deviated septum, or chronic sinusitis. By pinpointing these triggers, I can develop a personalized, evidence-based strategy that combines medical therapy with office-based procedures or surgery for lasting relief.
How Nasal & Sinus Assessment Works
At your consultation, Dr Prasad will take a thorough history of your symptoms — including how long they have been present, what makes them better or worse, and any relevant medical history such as asthma or previous nasal surgery.
Nasal endoscopy is performed in clinic: a thin, flexible or rigid telescope is passed into the nasal passages to directly visualise the internal nasal anatomy, the sinus openings, and any polyps, mucosal changes, or structural abnormalities. This is well tolerated by most patients and takes only a few minutes.
Where indicated, a CT scan of the sinuses provides detailed anatomical information about the extent of disease and sinus drainage pathways — essential for surgical planning. Allergy testing may also be recommended.
Treatment Options
Medical Management
Many nasal and sinus conditions are well managed with medication, and this is always the starting point where appropriate.
- Nasal steroid sprays: The cornerstone of treatment for allergic rhinitis, chronic sinusitis, and nasal polyps. Most effective when used consistently and with correct technique.
- Saline irrigation: Regular nasal saline rinses (using a neti pot or squeeze bottle) help clear mucus, reduce inflammation, and improve the effectiveness of topical sprays.
- Antihistamines: For allergic rhinitis with prominent sneezing and itching. Available in non-sedating oral formulations and nasal sprays.
- Short courses of oral steroids: Used to rapidly shrink nasal polyps or provide short-term relief in severe flare-ups of sinusitis.
- Antibiotics: For bacterial sinusitis, when clinically indicated. Not all sinusitis requires antibiotics.
- Biological therapies: For severe, recalcitrant chronic rhinosinusitis with nasal polyps, newer injectable biological agents targeting the type-2 inflammatory pathway can significantly reduce polyp burden and improve quality of life.
Surgical Treatment
Surgery is considered when medical management has failed, symptoms are significantly impairing quality of life, or there is a structural cause that medication alone cannot address. All procedures are discussed in detail before any decision is made.
- Functional Endoscopic Sinus Surgery (FESS): The gold-standard surgical approach for chronic sinusitis and nasal polyps. Performed entirely through the nostrils using a fine endoscope and precision instruments, FESS opens the natural drainage pathways of the sinuses and removes diseased tissue or polyps. There are no external cuts and recovery is generally two to three weeks.
- Septoplasty: Surgical correction of a deviated nasal septum, performed through the nostrils. Often combined with turbinate reduction to maximise nasal airflow. Recovery is one to two weeks.
- Turbinate reduction: Reduction in the size of enlarged inferior turbinates using radiofrequency or surgical techniques, improving nasal airflow with minimal recovery time.
- Balloon sinuplasty: A minimally invasive technique using a small balloon to dilate blocked sinus openings, suitable for selected patients with less severe disease.
Conditions Managed
Chronic rhinosinusitis (CRS) is inflammation of the nasal passages and sinuses lasting twelve weeks or more, despite treatment attempts. It can have a substantial impact on daily life — affecting sleep, energy, concentration, and sense of smell. CRS exists in two main forms: with or without nasal polyps. Differentiating between the two is crucial for tailoring correct treatment, which may range from nasal steroids to functional endoscopic sinus surgery (FESS).
Chronic Rhinosinusitis
Nasal Polyps
Nasal polyps are soft, non-cancerous growths that develop from the lining of the nasal passages or sinuses, often due to chronic inflammation. They can cause significant nasal obstruction, loss of smell, and facial fullness. While small polyps may respond to steroids, larger ones often require surgical removal via FESS. Biological therapies are also a newer option for severe cases.
A deviation in the cartilage and bone dividing the nasal cavity can obstruct airflow, contributing to snoring, mouth breathing, and exercise difficulty. Septoplasty is the established surgical procedure to straighten the septum, performed entirely through the nostrils. It is often combined with turbinate reduction for maximum functional improvement.
Deviated Nasal Septum
Allergic Rhinitis
Allergic rhinitis is an immune response to airborne allergens like dust mites, pollen, or dander. In Singapore, house dust mite allergy is particularly prevalent due to the climate. Management involves allergen avoidance, steroid sprays, antihistamines, and immunotherapy. ENT assessment is essential when symptoms are severe or complicated by sinusitis.
Recurrent Acute Sinusitis
Acute sinusitis is a short-term infection causing facial pain and congestion. While most episodes resolve naturally, recurrent cases (four or more times per year) warrant a formal ENT assessment. This helps identify underlying anatomical or inflammatory factors that can be addressed to stop the cycle of infection.
Turbinate Hypertrophy
Turbinates are structures that humidify air inside the nose. When persistently enlarged due to allergy or infection, they cause significant nasal obstruction. Turbinate reduction, often performed by radiofrequency or surgical trimming, is a straightforward procedure that can dramatically improve airflow, frequently performed alongside septoplasty.
Frequently Asked Questions
What is the difference between sinusitis and a sinus infection?
The terms are often used interchangeably. Sinusitis literally means inflammation of the sinuses, which can be caused by a viral or bacterial infection, allergies, or structural obstruction — not always infection. Acute sinusitis is a short episode, typically following a cold. Chronic sinusitis persists for twelve weeks or longer and often has a more complex underlying cause.
Do I need surgery for nasal polyps?
Not necessarily. Small nasal polyps often respond well to nasal steroid sprays or a short course of oral steroids. Surgery (FESS) is considered when polyps are large, causing significant obstruction or smell loss, or when they fail to respond adequately to medication. Even after surgery, ongoing medical treatment is important to reduce the chance of polyps returning.
What does septoplasty involve and will it change the shape of my nose?
Septoplasty is performed entirely through the nostrils and corrects the internal cartilage and bone causing obstruction. It does not change the external shape of the nose. If you also wish to change the shape of your nose cosmetically, this can be addressed at the same time with rhinoplasty — a combined procedure known as septorhinoplasty.
How long does recovery take after sinus surgery?
Most patients take one to two weeks off work after FESS. There is typically some nasal congestion, crusting, and mild discomfort in the first week as the nose heals. Nasal saline rinses are important during recovery to keep the sinuses clean. Full improvement in symptoms develops gradually over six to twelve weeks as healing and mucosal recovery progress.
Can allergic rhinitis be cured?
Allergen immunotherapy (desensitisation) is the only treatment that can modify the underlying allergic response rather than simply controlling symptoms. It involves gradually increasing exposure to the offending allergen over a period of months to years. Results are durable in many patients. For most people, however, the mainstay of treatment is good symptom control with nasal sprays, antihistamines, and allergen avoidance.
I lost my sense of smell after COVID. Will it return?
Post-COVID smell loss (anosmia or parosmia) affects a significant proportion of people who contract COVID-19. For most, some recovery occurs within weeks to months, but a smaller number experience prolonged or permanent changes. Platelet-Rich Plasma (PRP) therapy is an emerging treatment showing promising results — delivered directly to the olfactory cleft, it targets the nerve endings responsible for smell and may accelerate recovery. Smell training (repeated, deliberate sniffing of strong, familiar scents) remains a useful complement. ENT assessment is recommended early to explore all treatment options, including PRP.
Is a blocked nose on one side always serious?
One-sided nasal blockage is worth having assessed, particularly if it is persistent or progressive. In many cases the cause is a deviated nasal septum pushing towards one side, an enlarged turbinate, or a unilateral polyp. Rarely, one-sided nasal blockage can indicate a more significant lesion — which is precisely why it should not be left uninvestigated if it persists.
Further reading on smell and nasal conditions
Why smell loss happens and what treatment options are available in Singapore.
Why some patients don’t recover smell after COVID-19, and what the latest evidence says about treatment.
How PRP therapy works for smell loss and who is a suitable candidate.
