Functional Endoscopic Sinus Surgery

Functional Endoscopic Sinus Surgery or FESS for short is a medical term given to an operation that is recommended for patients suffering from severe or difficult-to-treat conditions of sinusitis. It combines the use of endoscopes and CT scan techniques to diagnose and treat sinusitis. FESS is one of the many approaches applied to cure sinusitis. The type of the surgical technique that needs to be adopted depends on which part the patient has been affected with sinusitis.

Diagnosis for the FESS surgery

1. Rigid Nasal Sinus Endoscopy

Prior to the surgery, a diagnosis is conducted to analyze the severity of the infection. For this purpose a small instrument called Rigid Nasal Sinus Endoscopy or commonly known as the FESS microscope is inserted in through the nostrils. This apparatus has a high intensity headlight with lenses having flexible angles. This enables the surgeon to check for any sign of infections in the sinuses and for any source of pus drainage in any nook and corner of the nasal cavities

2. CT Scan Technique

The CT Scanning provides better and clearer information than just simply using the Functional Endoscopic Sinus Surgery microscope. CT Scanning is mainly considered to investigate the interiors of the sinuses by providing a sharp picture of the insides of the nose. Hence combining the results acquired from the two techniques the surgeon gets a better idea of the problem of the patient. If required the surgeon recommends the patient to undergo the FESS.

FESS Surgical Procedure

FESS is usually conducted under general anesthesia depending on the severity of the sinus infection. The surgery in most cases does not involve any cuttings and hence bleeding is very rare. The FESS microscope is also utilized for the operation and the following functions are performed during the operation:

• The surgeon inserts the microscope through the nostril to see around the corners of the sinuses.
• The microscope guides the accurate surgical removal of the bones and polyps by using specially designed bone cutting instruments.
• Open up the blocked passages of the sinuses to ensure better drainage of the nasal fluids and pus.
• Anything blocking the passageways such as swollen mucous will also be removed.
• Ventilation is enhanced and sinus passageways are cleared.

General Post-Surgical Instructions

Immediate bed rest for a few hours will be required by the patient and food intake will be allowed once the surgeon is satisfied with the patient’s condition. The blood pressure and breathing will be regularly monitored by a nurse. Nasal bleeding is quite normal after a surgery and will stop within some hours.

The patient can expect to be discharged on the same day as that of the surgery or the next day depending upon the duration or success of the surgery.

Post-surgery Care

The days after a surgery is quite important and certain instructions need to be followed for a quicker recovery. Some of them are:

• Make sure the patient has all the medications prescribed by the surgeon
• Attend a follow-up appointment with the surgeon for analyzing the success of the surgery
• Steam inhalations are advised for clearing the nasals.
• Avoid dust and smoky environments.
• Heavy blowing through the nose for the first 48 hours is also not advised.

Advantages of FESS

Performing FESS for sinusitis patients with severe conditions is advantageous because of the following reasons:

• The procedure is fairly simple and does not involve much post surgical complications.
• FESS rarely involves cutting of the face or mouth and hence results in lesser bleeding.
• Certain studies have shown that about 90% of FESS cases were successful.