What Is Functional Endoscopic Sinus Surgery (FESS)?
Functional endoscopic sinus surgery (FESS) is a minimally invasive procedure used to treat severe sinus problems, such as chronic sinusitis, nasal polyps, and blocked sinuses. Healthcare professionals use a thin nasal endoscopes, slender tubes equipped with lights and lenses, to reduce sinus symptoms without the need for any incisions in or around the nasal area.
Research indicates that between 80% and 90% of individuals undergoing this surgery experience significant relief from their sinus issues.
1 to 2 Hours
Surgery Duration
General Anesthesia
Anesthesia Used
4-6 Weeks
Full Recovery Timeline
When FESS Surgery is Recommended?
Functional Endoscopic Sinus Surgery (FESS) is usually suggested when medical treatments like antibiotics, nasal sprays, or other therapies do not provide enough relief. The indications of FESS include:
- Have chronic or recurrent sinus infections that don't respond to medication
- Chronic Sinusitis not improving with medicines
- Nasal Polyps causing blockage or breathing difficulty
- Recurrent Sinus Infections despite treatment
- Fungal Sinus Infections requiring surgical clearance
- Deviated Nasal Septum with Sinus Issues
- Obstruction of Sinus Drainage Pathways
- Facial Pain, Pressure, or Headaches due to sinus blockage
- Complications of Sinus Infections (such as orbital or intracranial spread)
Preparation Guide for Functional Endoscopic Sinus Surgery (FESS)
Healthcare providers typically assess your medical history and conduct a physical examination to determine the need for FESS.
- Nasal endoscopy: Your healthcare provider employs an endoscope to examine your nasal passages and sinuses for any indications of infection or inflammation.
- Computed Tomography (CT) Scan: This diagnostic procedure assists your healthcare provider in identifying the specific areas of your sinuses that are affected.
- Medication Review: Inform your doctor about all medications, including blood thinners, as some may need to be stopped before surgery. You may be prescribed antibiotics or nasal sprays to prepare your sinuses.
- Fasting Instruction: If general anesthesia is planned, you will be advised not to eat or drink for 6-8 hours before surgery.
- Lifestyle Adjustments: Avoid smoking and alcohol, as these can slow healing and increase the risk of complications.
- Arrange Support: Plan for someone to accompany you to the hospital and assist during the initial recovery period at home.
Steps of FESS Surgery Procedure
Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure used to treat chronic sinus problems that do not respond to medications. During this surgery, doctors use a special camera called an endoscope to view and clear the sinus passages without making external cuts. The goal is to remove blockages, restore normal sinus drainage, and improve breathing. Below are the key steps involved in the FESS surgery procedure:
- Anesthesia: The surgery is usually performed under general anesthesia, but sometimes local anesthesia may be used.
- Use of Endoscope: A thin tube with a light and camera (endoscope) is gently inserted through the nostrils. This allows the surgeon to see inside the nasal passages and sinuses without making external cuts.
- Removal of Blockages: Using fine surgical instruments, the surgeon carefully removes polyps, inflamed tissue, or bone that is blocking the sinuses. This opens the natural drainage pathways of the sinuses.
- Restoring Drainage: By clearing the blockage, mucus can flow out properly, reducing infection and improving breathing.
- Completion: Once the sinuses are opened and cleared, the instruments are removed. No external scars are left since the entire procedure is done through the nostrils.
- Duration: The surgery usually takes about 1-2 hours, depending on the complexity.
Who Performs FESS Surgery?
Functional Endoscopic Sinus Surgery (FESS) is a specialized procedure performed by ENT (Ear, Nose, and Throat) surgeons, also known as otolaryngologists.
ENT Specialists (Otolaryngologists)
- FESS is typically performed by ENT surgeons who are specially trained in treating sinus, nasal, and airway disorders.
- They use advanced endoscopic instruments to safely open blocked sinus passages.
- In complex or severe sinus cases, the surgery may be done by an ENT surgeon with additional fellowship training in rhinology or endoscopic sinus surgery.
- In rare cases involving tumors or skull base conditions, ENT surgeons may work together with neurosurgeons.
Recovery After FESS Surgery
Following the surgery, you will be monitored in a recovery room by your healthcare provider. Your healthcare provider will guide you on post-surgery care. Here are some general instructions to keep in mind:
- Initial Discomfort: Mild pain, congestion, or pressure in the nose is common. These symptoms gradually improve within a week.
- Bleeding: Small amounts of blood-tinged discharge may occur for a few days. Heavy bleeding is rare but should be reported to your doctor.
- Nasal Care: Saline sprays or rinses are often recommended to keep the nasal passages clean and promote healing.
- Activity Restrictions: Patients are advised to avoid strenuous activity, heavy lifting, and bending forward for at least 1-2 weeks.
- Follow-Up Visits: Regular follow-up appointments are needed so the surgeon can check healing, clean crusts, and ensure proper recovery.
- Return to Normal Routine: Most people can return to work and daily activities within 1-2 weeks, but complete healing may take a few weeks longer.
Lifestyle Changes After Functional Endoscopic Sinus Surgery (FESS)
- Avoid smoking and alcohol as they can irritate the nasal passages and delay healing.
- Stay away from dust, strong odors, and allergens to reduce the risk of sinus irritation or infection.
- Use a humidifier at home to keep the air moist and prevent dryness in the nasal passages.
- Follow a healthy diet and stay hydrated to support faster recovery.
- Practice good nasal hygiene with saline rinses as advised by your doctor.
- Take medications as prescribed (antibiotics, nasal sprays, or pain relievers).
- Maintain regular follow-up visits with your ENT doctor to ensure proper healing.
Benefits of FESS Surgery
Functional Endoscopic Sinus Surgery (FESS) is a safe and effective procedure designed to treat chronic sinus problems. It not only targets the underlying cause of sinus issues but also offers several advantages that help patients breathe better, reduce infections, and enjoy a faster recovery.
- Minimally invasive with no external cuts.
- Improves sinus drainage and reduces infections.
- Relieves symptoms like nasal blockage, headache, and facial pain.
- Enhances sense of smell and overall breathing.
- Shorter recovery time compared to traditional surgery.
- Improves quality of life by reducing dependence on medications.
Potential Risks and Complications of FESS Surgery
FESS is generally safe, but like any surgery, it carries some risks. Possible complications include:
- Bleeding: As with any surgery, there is a risk of bleeding, though this is usually minimal and can be managed effectively.
- Infection: Although rare, there is a risk of infection post-surgery, which can be treated with antibiotics.
- Scar Tissue Formation: Some patients may develop scar tissue, which can affect sinus drainage and may require additional treatment.
- Vision Problems: Since the sinuses are located near the eyes, there is a slight risk of injury to the eye or surrounding structures, leading to vision issues, though this is very rare.
- Reduced Sense of Smell: Some patients may temporarily or permanently notice changes in smell.
- CSF Leak: There is a small risk of cerebrospinal fluid (CSF) leakage if the thin bone separating the sinuses from the brain is damaged, which may require further surgery to repair.
- Incomplete Symptom Relief: In some cases, symptoms may not be fully resolved, or they may recur, necessitating further treatment or surgery.
Cost of Functional Endoscopic Sinus Surgery (FESS) in India
The cost of Functional Endoscopic Sinus Surgery (FESS) in India typically ranges from Rs. 25,000 to Rs. 1,50,000, with an average around Rs. 80,000. In metro cities, it often falls between Rs. 40,000 and Rs. 1,20,000, while tier-2 and tier-3 cities may see rates as low as Rs. 38,000. Variations depend on hospital facilities, surgeon's experience, the complexity of the case, and the included services.
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