Functional Endoscopic Sinus Surgery (FESS)

Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive surgical procedure used to treat sinusitis, nasal polyps, and other conditions affecting the sinuses. The goal of FESS is to restore normal drainage and function to the sinuses, improving breathing, reducing congestion, and alleviating symptoms such as headaches and facial pain.

Indications for FESS

• Chronic sinusitis that does not respond to medical treatment
• Nasal polyps that obstruct the nasal passages or sinuses
• Deviation of the nasal septum (a crooked partition between the nostrils)
• Tumors or cysts in the sinuses
• Obstruction of the sinus ostia (the openings that connect the sinuses to the nasal cavity)

Procedure Overview

FESS is typically performed under general anesthesia. The surgeon uses an endoscope, a thin, flexible tube with a camera and light on the end, to visualize the sinuses and surrounding structures. The endoscope is inserted through the nostrils, allowing the surgeon to access the sinuses without making external incisions.

The procedure involves several steps:

1. Insertion of the endoscope and examination of the nasal cavity and sinuses
2. Removal of any blockages, such as polyps or bone fragments, that are obstructing the sinus ostia
3. Enlargement of the sinus ostia to improve drainage
4. Removal of infected tissue or debris from the sinuses
5. Correction of any anatomical abnormalities, such as a deviated septum

Benefits and Risks

The benefits of FESS include:

• Improved sinus drainage and function
• Relief from symptoms such as congestion, headaches, and facial pain
• Reduced need for medications and other treatments
• Minimally invasive procedure with reduced risk of complications

The risks and potential complications of FESS include:

• Bleeding or hematoma
• Infection
• Damage to surrounding structures, such as the eyes or brain
• Nasal septal perforation (a hole in the thin wall of cartilage and bone between the nostrils)
• Adverse reactions to anesthesia

Postoperative Care and Recovery

After FESS, patients typically experience some nasal congestion, swelling, and discomfort. The surgeon may prescribe medications to manage pain, reduce inflammation, and prevent infection.

Patients are usually advised to:

• Avoid heavy lifting, bending, or strenuous activities for several days
• Use saline nasal sprays or irrigations to keep the nasal passages moist and promote healing
• Avoid blowing their nose or sneezing with their mouth closed
• Follow a postoperative care plan provided by the surgeon

Most patients can return to normal activities within 1-2 weeks after FESS. However, it may take several months for the sinuses to fully heal and for symptoms to completely resolve.