Endoscopic Sinus Surgery (FESS)
Endoscopic sinus surgery is a surgical procedure that is used to open the pathways of the sinuses so mucous can drain properly. During this procedure, doctors remove the bone and mucous membranes that are blocking the sinus passageways by using a fiberoptic telescope that eliminates the need for a surgical incision in the skin. Endoscopic Surgery, when indicated, provides modern solutions to chronic conditions of the Nose and Sinuses, such as Chronic Rhinosinusitis, Nasal Polyps and benign and malignant tumours.
Indications for Endoscopic Sinus Surgery
Endoscopic sinus surgery is most commonly performed for inflammatory and infectious sinus disease. The most common indications for endoscopic sinus surgery are as follows:
- Chronic sinusitis refractory to medical treatment
- Recurrent sinusitis
- Nasal polyposis
- Antrochoanal polyps
- Sinus mucoceles
- Excision of selected tumors
- Cerebrospinal fluid (CSF) leak closure
- Orbital decompression (eg, Graves ophthalmopathy)
- Optic nerve decompression
- Dacryocystorhinostomy (DCR)
- Choanal atresia repair
- Foreign body removal
- Epistaxis control
A thorough history and a complete physical examination, including nasal endoscopy will be performed.
The history will include the frequency of infections, the type and the duration of symptoms, and the response to medical therapy. Patients with chronic or recurrent symptoms typically report the following symptoms:
- Nasal congestion
- Purulent drainage
- Postnasal drip
- Facial pressure and headache
- Hyposmia or anosmia
- Nasal obstruction
A CT scan is necessary before the surgery in order to determine the anatomy of he sinuses and locate any obstructions that may be impeding proper drainage of the sinuses.
Benefits of Functional Endoscopic Sinus Surgery
The benefits of functional and image guided endoscopic sinus surgery include:
- No external scarring as the whole procedure is done through the nose
- The procedure is minimally invasive, therefore there is less removal of normal tissue which typically results in less bleeding and pain
- Shorter recovery time than with traditional open surgery
It can take several weeks for full recovery. There might be some swelling and tenderness inside the nose after the surgery, but this is normal. The symptoms may seem like a severe cold or a sinus infection. This is due to swelling, dry blood, mucous, and crusting in the nose. In order to promote a quicker recovery nasal irrigation or saline sprays are recommended and antibiotic lubricants and corticosteroid sprays are often used for a short period of time.