FESS or Functional Endoscopic Sinus Surgery, is surgery to treat chronic sinusitis. The surgeon uses a camera called an endoscope and special instruments through the nose to open up the sinuses. There are no cuts on the outside of the nose or face. The goal of the surgery is to enlarge the natural opening to the sinuses so they can drain more easily. In most people, there are four sinuses on each side of the head, making a total of 8. In some people all 8 sinuses need to be opened, and some people need only a few, depending on what the doctor sees on exam and on CT scan. The length of the surgery depends on how many sinuses need to be opened, but patients can usually go home the same day or surgery.
What conditions does FESS treat?
Patients may need sinus surgery for the following conditions:
- Chronic bacterial sinusitis
- Allergic fungal sinusitis
- Recurrent acute sinusitis
- Nasal Polyps
For many people, one sinus surgery will be enough to treat their condition if they continue with sinus wash and medication as needed after the surgery. However, some people will need another surgery, called a Revision FESS to feel better again. The reasons a patient may need another surgery can be because the chronic infection comes back after several years, the polyps grew back, different sinuses are infected since the first surgery, or because the opening to the sinus scarred shut. In these cases the surgeon will use the endoscope to open any sinuses that are affected. In these cases many of the usual landmarks the surgeon uses to navigate the sinuses may be removed from the previous surgery. In revision cases it is very important to use a navigation system, or computer aided sinus surgery. Using the navigation system, the surgeon can find the areas that need to be opened and do so safely.
The recovery from a revision FESS is similar to the first time surgery. You might have some light packing in your nose which will dissolve over the first few days. Most patients can go home the same day.