Functional Endoscopic Sinus Surgery (FESS)

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


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.

During the Procedure

FESS procedures take place in a hospital. A typical procedure includes:

Local or General Anaesthesia:

The patient is sedated so that no pain is felt during the surgery.

Insertion of Endoscope:

The surgeon will pass an endoscope (thin fibre-optic tube with a camera) through your nose to access sinus cavities and take images.

Tissue Repositioning or Removal:

The surgeon will reposition or remove nasal tissue or polyps that interfere with proper nasal drainage with small, precision instruments. In some cases, the surgeon may opt to insert a spring-like implant known as Propel into the surgery site. This device keeps the affected area open while releasing a controlled dose of cortisone to prevent polyp regrowth and scar formation. Over the course of a month, the device degrades.

Minimising bleeding:

Now, the surgical tools are taken out and dissolvable nasal packing is kept inside your nose to minimise bleeding.

After the Procedure

  • Patients can expect minimal swelling and pain for about a week after the procedure. The majority of patients will also experience congestion during this period.
  • Patients can usually return home the same day as the procedure. Following the recovery period, patients usually report a significant improvement in their ability to breathe. Most patients are able to resume their normal activities within a week.
  • Do not blow your nose for the first week after surgery. Furthermore, during the first week, you should not bend, strain, or lift more than 20 pounds. Only light walking and regular household activities are permitted after surgery.
  • Once the initial one week is over, you can resume to moderate intensity workouts. And after about two weeks, you may resume to full intensity exercises. For this surgery, you will need one week off from work.

Risks of Surgery

Endoscopic sinus surgery has associated risks as with any surgical procedure. Although the chances of a complication occurring are extremely low, it is critical that you are aware of the risks which include:

  • Bleeding
  • Recurrence of disease
  • Leak of fluid from your brain
  • Visual problems
  • Other uncommon risks of surgery include changes in smell or taste, the persistence or worsening of sinus symptoms and facial pain. A change in the resonance or quality of the voice, and swelling or bruising around the eye.

FESS 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.

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Frequently Asked Questions

1. Will I need to have surgery ever again?

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.

2. How long is the FESS surgery?

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.

3. Will there be bleeding of the nose after sinus surgery?

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

4. Is the sinus surgery permanent?

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.

5. How long will my teeth hurt after FESS?

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

6. What are the conditions which can be treated with FESS?

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

7. What are the risks of sinus surgery?

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

8. What are the symptoms of sinusitis?

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

9. How long does it take to recover from endoscopic sinus surgery?

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.

10. Can I sneeze after sinus surgery?

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.