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Functional Endoscopic Sinus Surgery (FESS)

What is Functional Endoscopic Sinus Surgery?

Functional endoscopic sinus surgery (FESS), is a common and traditional surgical method to treat chronic sinus infections and/or nasal polyps. In a FESS surgery, an ENT surgeon typically takes the patient to the operating room under general anesthesia. Nasal endoscope and sinus CT navigation are used to remove infected bone and tissue to open up the sinus drainage pathways and clean out infection. After the sinuses heal, the sinus openings are surgically enlarged to keep recurrent sinus infections from happening again.

FESS Applications for Surgery

  • Chronic Sinusitis
  • Sinus Polyps
  • Fungal Sinusitis
  • Severe Sinus Infections

When the sinuses are blocked, infection and bacteria are trapped, which can lead to inflammation that festers and lingers. Trapped infection causes inflammation and pressure, felt as a headache or facial pressure. Infected sinuses also produce secretions such as phlegm, runny nose, or post-nasal drip, which causes a person to clear their throat often.

What Does FESS Do?

The FESS procedure alleviates these issues by opening the sinuses. With surgery, the sinus opening is enlarged by removing the specific parts that block the sinuses. Then the sinus is suctioned clear. The sinus is now open and can keep itself clear. Inflammation goes down, bacteria go away, and secretions are cleared out. The end results in sinusitis symptoms go away.

The correction rate for Endoscopic Sinus Surgery is 97+%, the same as balloon sinuplasty. Both treatments can be done in an office or a hospital setting. When comparing FESS vs sinus balloon procedures, both treatments can be performed in an office or a hospital setting, depending on the severity of the patient’s condition and anatomical needs.

Recovery After FESS

Everyone’s body recovers and reacts differently after medical procedures, but typically recovery from FESS takes 1 to 2 weeks. Patients are discharged from the hospital/surgery center same day of surgery. Nasal congestion and moderate sinus pressure/pain are normal. Mild oozing and bleeding for the first 24 hours after surgery can also be normal. Pain is well-controlled with prescription pain medications and alternating Tylenol. Typically splints and/or packing are placed in the nasal cavities as well. This may make breathing through your nose difficult for the first week. Patients are seen for their 1 week postop and a nasal debridement is performed. At this time patient can start to see the improvements from surgery. Patients are started on twice daily nasal saline rinses and antibiotics are completed. Because FESS is more invasive than balloon sinuplasty recovery takes longer, but long term results are typically similar. When sinus infections are severe or nasal polyps are found, FESS can be a more appropriate treatment option than balloon sinuplasty.