FESS Surgery


By Dr SRS Pavan Kumar Kannuru
MBBS, MS (ENT), MCh
Consultant Ear,Nose,Throat and Head & Neck Surgeon

Article Context

  1. Overview
  2. Benefits of FESS surgery
  3. Procedure
  4. Care at Medicover
  5. Frequently Asked Questions

Overview

Functional Endoscopic sinus surgery(FESS)is a procedure that opens the sinuses for natural pathways of drainage in order to restore their function and health. Chronic sinusitis causes the sinuses to be unable to drain properly due to inflammation of the narrow drainage pathways. As a result, nasal secretions can become trapped in the sinuses and infect them over time. Symptoms of chronic sinusitis are nasal congestion, facial pressure, toothache, headache, running nose, altered sense of smell, discoloured nasal discharge, fatigue and fever.

What are the Indications of FESS?

FESS surgery is recommended for patients who have not found relief from chronic sinusitis despite trying numerous conventional medications and antibiotic courses. Surgery is the best option if you have one or more of these conditions:

  • Deviated nasal septum
  • Nasal polyps
  • Acute sinusitis for four or more times per year
  • Sinusitis which is present for more than three months
  • Chronic sinusitis that does not respond to antibiotics or other treatments
  • Enlarged nasal turbinates

What are the benefits of FESS Surgery?

FESS has many advantages over traditional sinus surgery options.The main advantages include:

  • Minimally invasive surgery
  • Minimal pain
  • No outward scarring of nose
  • Few surgical complications
  • Little post-surgical bleeding
  • Reduced tissue removal

Procedure

Before the procedure:

  • Your doctor may advise blood tests such as complete blood count, C- reactive protein, erythrocyte sedimentation rate.
  • You may also be advised to undergo X- ray and CT- scans.
  • Your physician may prescribe preoperative medications to optimise the condition of your sinuses for surgery. Antibiotics and oral steroids may be prescribed as well. Please start any preoperative medications on the appropriate day and follow the prescription precisely.
  • In addition, you should avoid taking blood thinners for at least fourteen days prior to surgery. These medications have the potential to thin the blood and cause excessive bleeding.
  • You must stop smoking for at least three weeks before surgery and for at least four weeks following surgery as it can contribute to scarring, poor healing, and surgical failure.
  • Majority of the required pre-operative testing will be completed on the day of your preoperative visit which may also require examination of your previous records.

Care at Medicover Hospitals

At Medicover, Our ENT specialists are equipped with knowledge of advanced technologies and have vast experience to perform sinus surgery with a mission to bring international standards in the field of comprehensive ENT services. Our patient friendly environment that prioritises patient’s safety and comfort have made us the best ENT care hospital.

Frequently Asked Questions:

Surgery and ongoing medical therapy, such as sinus irrigations, steroid sprays, and allergy pills, can usually keep you from needing surgery again. Some patients will improve only through surgery. But not everyone has the same severity of sinus problems.

The operation can take between one and two hours, making it a fairly quick procedure. It is rare that you would have to stay in a hospital overnight.

You may have some bleeding which may continue over the week. However, you will be provided with padding or gauze to absorb it.

The surgery will allow your airways to be open and become clearer. But some cases may require you to return in a few years as tissue may grow back.

After your surgery, the upper teeth or roof of your mouth may feel sore. This may last for 2 weeks.

Many types of nasal problems such as chronic sinusitis, nasal polyps, recurrent sinus infections, nasal obstruction can be treated.

Few of the risks of sinus surgery are bleeding, infection, cerebrospinal fluid leak, visual problems and voice changes.

Sinusitis can cause nasal congestion, discoloured nasal discharge, toothache, headache, facial pressure, running nose, altered sense of smell, fatigue and fever.

You should be able to return to work in about a week and to your regular routine in about three weeks. However, this depends on your job and the extent of your surgery. Most people return to normalcy within 1 to 2 months. You need to see your doctor on a regular basis for 3 to 4 months.

Do not blow your nose for one week after surgery. If you feel the need to sneeze, do not try to suppress it. Instead sneeze with your mouth open. You may experience nose bleeds for several days following surgery.

Citations:

  • https://www.healthdirect.gov.au/surgery/endoscopic-sinus-surgery
  • https://med.stanford.edu/ohns/OHNS-healthcare/sinuscenter/resources/sinus_guide.html
  • https://www.entcanada.org/learning/general-public/public-information-sheets-2/nose/endoscopic-sinus-surgery/