About Dr Narinder Singh
Dr Narinder Singh is an expert and authority on nasal polyps.
Dr Singh trained as an Ear Nose & Throat (ENT) Surgeon in Sydney, Australia.
Dr Singh was then awarded a 3 year fully-funded Nose and Sinus Fellowship at the world-renowned Guy's and St Thomas' Hospitals in London, England. During this time he undertook laboratory research into nasal polyps at King’s College, London. This led to the publication of his Master of Surgery Research Thesis through the University of Sydney.
Dr Singh is Head of the ENT Dept at Westmead Hospital, Sydney, Australia’s largest healthcare campus.
Dr Singh is a Clinical Lecturer at the University of Sydney, Australia’s oldest and largest medical school.
Click here to download a copy of Dr Singh's Thesis, for the award of Master of Surgery from The University of Sydney, entitled "Allergen Specific Cytokine Production by Cells Derived From Human Nasal Polyps"
- MBBS (Medical degree) - The University of Sydney, Australia
- MS (Master of Surgery)– The University of Sydney, Australia
- Student Electives –Yale University, Connecticut, USA and McGill University, Montreal, Canada
- Internship and Basic Surgical Training – Royal Prince Alfred Hospital, Sydney
- FRACS (ORL-HNS) –Fellowship of the Royal Australian College of Surgeons in Otolaryngology, Head & Neck Surgery (ENT)
- Nose and Sinus Fellowship (3 years) –Guy’s and St Thomas’ Hospitals, London, England and King’s College, London, England
- Consultant Surgeon and Head of ENT Department, Westmead Public Hospital
- Consultant Surgeon and Head of ENT Department, Hospital for Specialist Surgery
- Consultant Surgeon, Westmead Private Hospital
- Consultant Surgeon, Norwest Private Hospital
- Consultant Surgeon, Macquarie University Hospital
- Clinical Lecturer, The University of Sydney (Teaching a rotating team of trainee surgeons at the Westmead Hospitals campus, along with students of the University of Sydney and visiting international trainees from Europe and the Asia-Pacific region)
- Dr Singh treats ADULTS and CHILDREN
- Dr Singh treats patients from all over Sydney, country NSW, Interstate and Overseas (Many of Dr Singh’s patients are referred by other ENT surgeons)
- Nose and Sinus conditions
- Nasal Polyps Surgery
- Endoscopic sinus surgery, including Complex, Advanced and Revision cases
- Deviated Septum surgery
- Turbinate surgery
- Snoring surgery
- Blocked Nose surgery
- Broken Nose surgery
- Rhinoplasty (nose re-shaping), including Caucasian, Non-Caucasian and Complex cases
- Anterior Skull Base surgery
- Endoscopic (keyhole) surgery for tumours of the nose, sinuses, and anterior skull base
- Computerised Surgical Navigation ("GPS" for surgery)
Dr Singh is one of only a handful of Australian surgeons to be fully registered as an ENT specialist in both Australia and the United Kingdom (see Medical Board of Australia Website and UK General Medical Council Website)
- Royal Australasian College of Surgeons
- Australian Society of Otolaryngology, Head and Neck Surgery
- British Association of Otorhinolaryngologists, Head and Neck Surgeons
- ENT-UK Expert Panel
- European Rhinological Society
- International Rhinological Society
- European Academy of Facial Plastic Surgery
- Australian Society of Clinical Immunology and Allergy
- Australian Rhinological Society
- Australian Sleep Association
Dr Singh grew up on his family’s farm near Griffith in country NSW. He attended his local country high school and was awarded the Premier’s Medal for the Higher School Certificate.
His research has been funded by the UK Government (Guy’s and St Thomas’ NHS Foundation Trust), along with three separate research grants:
What are nasal polyps?
Nasal polyps are large, round lumps of flesh that grow to block the nose and sinuses.
What problems are caused by nasal polyps?
The two commonest problems caused by nasal polyps are:
- Blocked nose
- Reduced sense-of-smell
Nasal polyps can cause many other problems including some or all of the following nasal polyps symptoms:
- Blocked nose
- Stuffy nose
- Nasal congestion
- Reduced oxygen intake
- Noisy breathing
- Reduced sense-of-smell
- Reduced sense-of-taste
- Runny nose
- Post nasal drip
- Sinus pains
- Sinus problems
- Chronic sinusitis
- Blocked sinus
- Sore throats
- Tiredness during the day
- Sleepiness during the day
- Dark circles under the eyes
- Unhealthy gums
- Dry, cracked lips
- Tiredness/ fatigue
- Poor-quality sleep
- Waking up feeling tired
- Waking up with a dry mouth
- Waking up feeling thirsty and having to drink water
- Sinus infection
- Sinus pain
- Sinus headache
How can I find out if I have nasal polyps ?
Always see your GP first. Your GP will look inside your nose and may order some tests or prescribe some medications. If your GP cannot treat your nasal polyps, ask your GP for a referral to see Dr Singh, the nasal polyps specialist.
What tests can my GP order?
Some tests that your GP may order include:
- CT scan - This can show the extent of your nasal polyps and anatomy of your nose and sinuses
- Skin prick tests – These can show if you have allergy/hay fever (Allergic Rhinitis)
- RAST blood tests – These can show if you have allergy/hay fever (Allergic Rhinitis). Blood tests are not as accurate as skin prick tests but are easier to perform
What treatments can my GP prescribe?
Some treatments that your GP may prescribe include:
- Nasal saline rinse – This washes out the inside of the nose and sinuses using a neti pot or squeeze bottle
- Steroid nasal sprays – These may shrink the lining of the nose and polyps to allow more air through
- Antibiotics – These may be used to treat sinus infection or inflammation
- Strong medications – These may be used to temporarily shrink your polyps. These medications can have dangerous side effects and must be used under close medical supervision
What if the treatment from my GP doesn’t work?
Ask your GP for a referral to see Dr Singh for nasal polyps surgery.
TREATMENT WITH DR SINGH
What happens when I see Dr Singh?
Dr Singh uses special tests to examine your nasal polyps.
Dr Singh will pass a super-fine camera into your nose to look at your nasal polyps and sinuses (the nose is made numb first using a special numbing spray). You can watch the camera on a TV monitor and see your polyps for yourself.
Dr Singh may arrange a CT scan, allergy/hayfever tests, blood tests and tests of nasal airflow.
Our practice is unique as we have a CT-scanner on-site, along with an on-site allergy-scientist who will perform scientific testing of your allergies and nasal airflow. This means everything is done in one visit, instead of multiple appointments.
Despite all the tests and high-technology available, the single most accurate tool is your doctor’s knowledge, training and experience!
Can my nasal polyps be fixed?
In almost every case, nasal polyps can be effectively treated
How are nasal polyps treated?
After extensive testing, Dr Singh will prepare a personalised treatment plan, tailored just for you.
This will typically involve Surgery and Medications.
Dr Singh uses highly specialised instruments to carefully remove your nasal polyps, without harming the surrounding structures.
Nasal polyps surgery includes some or all of the following procedures:
- Polypectomy: This clears out all of your polyps
- FESS (Functional Endoscopic Sinus Surgery): This enlarges your sinus openings to reduce future problems
- Septoplasty: This corrects any deviation in your septum
- Inferior turbinoplasty: This helps improve your breathing
- Lothrop procedure: This opens your forehead sinuses
Dr Singh uses a highly specialised “Computer Surgical Navigation” System to ensure complete polyp clearance with no harm to surrounding structures.
After your procedure, Dr Singh will prescribe targeted medications to slow the return of your polyps.
Are there any risks to nasal polyps surgery?
Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks... but we still cross the street. Dr Singh will explain the risks of your nasal polyps surgery and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.
Are there any alternative treatments to nasal polyps surgery?
Yes. There are always options and it is always your choice as to whether to have nasal polyps surgery. In general, you can try other options first and choose surgery once other options have failed.
Non-surgical options include:
- Do Nothing. If your problem is not severe, you may choose not to have any treatment at all.
- Simple treatments (Saline rinse). Try rinsing the nose 2-4 times a day with salty water in a neti pot or bottle from your pharmacy.
- Medications. Try steroid nasal spray or antihistamine tablets/ sprays from your pharmacy or from your GP. They work best for people with allergy but may sometimes help people without allergy.
- Antibiotics for sinusitis. These may be useful if you have sinus infection symptoms or sinusitis.
- Strong Medications. Certain strong medications can help treat polyps, but carry the risk of side-effects and must be used under strict medical supervision. These include antibiotics, steroids and anti-leukotriene inhibitors.
We recommend that you see your GP first and consider trying these non-surgical options. Then see Dr Singh when you are ready for surgery.
There is a long waiting list to see Dr Singh and it is best if you see Dr Singh for nasal polyps surgery after the non-surgical treatments have failed.
What should I do next?
I have already seen a doctor – I was told nothing could be done for my nasal polyps. What should I do?
Most cases of nasal polyps can be fixed or improved. Dr Singh is the nasal polyps specialist and has expertise in difficult and complex cases.
I have already seen a surgeon and had an operation on my nose. It didn’t work! What should I do?
Most cases of nasal polyps can be fixed or improved. Dr Singh is the nasal polyps specialist and has expertise in performing revision surgery.
MORE DETAILED INFORMATION ABOUT NASAL POLYPS
Who gets nasal polyps?
Nasal polyps affect 1-4% of the adult population.
They most commonly occur after the age of 20 years, with a peak in patients aged between 50 – 60 years.
In children, nasal polyps are linked with Cystic Fibrosis.
What causes nasal polyps?
At this point in time, scientists do not know what causes nasal polyps!
There are many theories about possible causes. These include:
- Staphylococcal superantigen theory: nasal polyps may be caused by an immune reaction against a certain infectious bug.
- Injury and epithelial wound healing theory: nasal polyps may be caused by injury at contact points in the sinuses.
- Vasomotor-imbalance theory: Nasal polyps may be caused by reduced venous drainage and clearance of chemicals.
Are there any medical conditions linked with nasal polyps?
In most patients, nasal polyps occur by themselves.
In some patients, there is a link between nasal polyps and certain conditions:
- Sensitivity to Aspirin/ NSAID tablets
- Allergic Fungal Sinusitis
In a very small number of patients, there is a link between nasal polyps and certain rare conditions:
- Cystic Fibrosis
- Churg-Strauss syndrome
- Non-allergic rhinitis – eosinophilia syndrome (NARES)
- Primary Ciliary Dyskinesia
- Young’s Syndrome
What is Samter’s Triad?
Samter’s Triad is the combination of: Nasal Polyps, Asthma and Asprin Sensitivity.
Do nasal polyps grow back after surgery?
Yes. Nasal polyps are a disease. Surgery clears the polyps, but does NOT cure the underlying disease.
Nasal polyps grow back after surgery at different speeds, in different individuals. Some patients only ever need one procedure. Most patients come back after a few years for another procedure, typically between 3-8 years after their last operation. Very rarely, polyps can grow back in as little as 6 months!
Will I get my sense-of-smell back after nasal polyp surgery?
If you have lost your sense-of-smell because of nasal polyps, unfortunately, there is no guarantee that your sense-of-smell will return after nasal polyp surgery. In many cases, there will be a partial return, but this may be lost again, as the polyps grow back.
Can nasal polyps turn in to cancer?
No. Nasal polyps do not become cancerous.
Very rarely, a cancer in the nose or sinuses may be covered with nasal polyps, which may result in a missed diagnosis. Dr Singh carefully checks to make sure you don’t have a cancer by doing the following:
- Asking detailed questions
- Examining your nose and sinuses very carefully with special instruments
- Studying your scans and test results
- Sending biopsies of your polyps for laboratory study under a microscope
Polyps in the bowel (intestines) have a risk of turning into cancer. Nasal polyps do not.
Are there any new treatments being tested?
Yes. Scientists are experimenting with several new treatments that may or may not be effective in treating nasal polyps. These include:
Anti-IL5 (eg Reslizumab): This blocks part of the immune system.
Leukotriene receptor antagonists (eg Moteluekast): These may be helpful in patients with Samter’s triad.
What can I do to slow down nasal polyps re-growth after surgery?
Unfortunately, nothing has been proven to stop nasal polyps from growing back after surgery. We recommend the following:
- Comprehensive surgery, as practiced by Dr Singh, to remove as much polyp material as possible.
- Steroid tablets and drops after the procedure, in the short-term.
- Regular use of steroid nose sprays, in the long term.
- Regular use of saline washes in the nose and sinuses.
- Treating any allergies, especially allergy to certain types of fungus.
- Patients with Samter’s triad may have other treatment options.
What about miracle treatments/ natural/ home remedies for nasal polyps – do they work?
On the internet, many “miracle” and “alternative” treatments for nasal polyps can be found and purchased on-line.
Unfortunately, there is no scientific evidence to support their use. Some may contain unknown and possibly toxic ingredients.
We recommend against buying non-scientific treatments from on-line sellers, that are not supported by doctors, scientists and experts in the field.
I read on the internet that food allergy can cause nasal polyps – what do you think?
Unfortunately, there is no scientific evidence to support the theory that food allergies or food intolerance causes nasal polyps.
If you believe that a certain food is causing your nasal polyps, you could try a brief period of eliminating that food item from your diet. This should only be done under strict medical supervision, after discussing it with your GP. We do not recommend this practice, but if done briefly under medical supervision, it is generally low-risk.
Do you have a question about nasal polyps?
INTERESTING FACT / DID YOU KNOW?
Apart from humans, the only other species known to have nasal polyposis is the Chimpanzee!
DOWNLOAD A REFERRAL FOR YOUR GP
As Dr Singh is a specialist, to obtain a Medicare refund, you must have a GP referral for Dr Singh. This can be obtained from your regular GP or any doctor at any medical centre. You can download the attached referral form for convenience.