Ear, Nose & Throat (ENT) - Head & Neck Surgery
Allergic Rhinitis (Sinus)
The Department of Ear, Nose & Throat (ENT) - Head & Neck Surgery provides a wide range of surgical services for adult patients with ENT, head and neck diseases. Patients are referred from polyclinics, general practitioners, emergency services or transferred from other departments within the Ng Teng Fong General Hospital or other healthcare facilities, including nursing homes, community and other hospitals. Our team of highly-trained ENT-Head & Neck surgeons and allied healthcare professionals aim to provide the best possible care to our patients.
What is an allergy? An allergy is a condition that is inherited whereby the immune system of a person reacts to something in the environment or something he/she has eaten. An allergy is simply hypersensitivity or an abnormal reaction to a substance that is harmless to most people.
What is allergic rhinitis? Commonly referred to as “sinus”, allergic rhinitis relates to the nasal passages. Its main symptoms include watery running nose, excessive sneezing, nasal congestion and sometimes post-nasal drip. It can also be associated with coughs, throat irritation and eye itchiness. Related to allergic rhinitis is asthma, a hypersensitivity that involves the lower airways or lungs. Both conditions often co-exist and need to be well-controlled.
How is allergic rhinitis linked to asthma and other “allergic” conditions? The underlying reason for allergic rhinitis and asthma is hypersensitivity of the immune system. People with allergic rhinitis often also have other conditions such as asthma, skin eczema, allergic conjunctivitis, food allergies, etc.
What are allergens? Allergens are particles which trigger the immune system to produce a response. When allergic individuals are exposed to an allergen, e.g. house dust mite, their immune system produces an excessive response that results in immediate symptoms, such as sneezing, running nose, itch, and nasal congestion. In a normal (non-allergic) person, this same allergen would not cause any symptoms.
What am I allergic to? In Singapore, most people with allergic rhinitis are allergic to house dust mites and other allergens such as cockroaches, animal dander (fur), pollen, grass, fungus and mould, etc. To determine what you are allergic to, a skin prick test will need to be done at a Ear Nose and Throat clinic in a hospital. Common allergens in Singapore include:
House dust mite
Indoor mould
Outdoor mould
Cockroach
Dog fur
Cat hair
Bermuda grass
Common mugwort
How did I develop these allergies? Allergy is often inherited and starts early in life all the way to adulthood.
What are some treatment options available? At Ng Teng Fong General Hospital, the Ear Nose and Throat clinic can help you manage your allergies holistically through: • Consultations – by reviewing your medical history and conducting a physical examination, which includes a flexible fibre optic nasal endoscopy to exclude other nasal or sinus issues. • A skin prick test to identify allergens that may be triggering your symptoms. • Advise on environmental control at home and at work, which are essential in controlling your allergy symptoms. • Medication therapy - either nasal sprays or oral anti-histamines pills to control or prevent symptoms. • Immunotherapy to minimise allergy symptoms. Immunotherapy will relieve you of the need to be on long term nasal sprays or oral antihistamine pills. Please check with your doctor for more information if you are interested in this method. • Surgical options. Should your symptoms be associated with significant structural issues of the nasal passage, or your nasal congestion does not improve with medications, surgery may be advised. Surgery ranges from minor outpatient procedures to inpatient surgery, but it is important to note that surgery alone cannot cure allergy.
What is a skin prick allergy test? A skin prick allergy test is the most convenient and least expensive method to test for allergies. It helps you identify what inhalant allergens you are allergic to. Results can be known within 20 minutes.
Why is it important to know which inhalant allergens I am allergic to? Doing so helps you to avoid or reduce your exposure to specific allergens, and decrease or eliminate your allergy symptoms.
How is the test done? The test is performed on both forearms with the help of sterile lancets. A series of pricks will be made on your skin. Prior to the pricks the lancets are dipped in a container with allergens solution. If the pricked skin swells (wheal), turns red and itch, this may indicate a positive result.
What is immunotherapy? If your allergies persist despite avoiding allergens and taking the medications prescribed to you, your allergy doctor can prescribe immunotherapy to you. Immunotherapy challenges your body’s immune system through daily selfadministered drops and can begin as soon as you undergo a skin prick test. Over time, immunotherapy will alter your body’s excessive immune response to allergens and make you less “sensitive” to them. This will improve symptoms and reduce the need for you to take antihistamine medications, use nasal sprays or avoid specific allergens. Fewer symptoms can be expected as quickly as several months of starting immunotherapy. For best and long lasting results, treatment is recommended for 3 to 5 years.
How is immunotherapy administered? Immunotherapy is administered by using drops or spraying under the tongue. This is known as Sublingual immunotherapy (SLIT) and can be done at home. Once you and your doctor decide on immunotherapy as a treatment option, an allergy nurse can provide you with more information.
What can I do to help myself? • Use a HEPA air filter
A “High Efficiency Particulate Arrester” (HEPA) filter can remove as many as 99.7 per cent of particles in the air and down to a size of 0.3 micrometres. This takes most allergenic particles out of the air. It is recommended that you use one in the bedroom and one in the office.
• Clean regularly with a HEPA vacuum cleaner
Using a HEPA vacuum can be useful in decreasing the amount of allergens at home. HEPA vacuum cleaners are specially designed to filter dust, pet dander, and pollen from floors, rugs, and carpeting.
• Replace filter with allergyremoving filters
You can improve the air quality at home by replacing standard filters with allergen-removing filters.
• Mite-proof mattresses and pillow covers
Making your bedroom allergy-free is the first and best place to start. Use allergy covers for your mattress, pillows, and comforters to minimise allergen exposure.
• Wash bed linens weekly
Washing bed linens weekly in warm water (above 60C) can minimise your exposure to dust mites. Sun drying mattresses, pillows and comforters is also an effective method in minimising dust mite counts.
• Remove unnecessary fabric or carpets at home
As dust mite is the main allergen in Singapore, avoid places where they can accumulate. These include carpets and fabric sofas.
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