FESS – Functional Endoscopic Sinus Surgery

FESS (Functional Endoscopic Sinus Surgery) is nasal surgery involving the use of an endoscope to access the nose and the sinuses, as well as skull base.

It is usually performed under general anaesthesia but if there are other general health problems, it can be done under local anaesthesia and sedation.

The surgery is minimally invasive and can correct a bend cartilage in the nose (endoscopic septoplasty), treat chronic sinusitis by opening the passages to the sinuses, remove polyps, etc.

Complications of surgery:

1) General: Bleeding (risk 1 in 50), infection (risk 1 in 100), pain, DVT or blood clot in the legs/ PE or blood clot in the lungs

2) Specific: Adhesions (webs from one side of the nostril to the other), damage to the eye socket (orbit) as the sinuses are separated from the eyes only from a very thin piece of bone. Then the result may be a bruising around the eye or larger collection of blood (haematoma), double vision or even blindness (risk 1 in 500), leak of fluid from the brain (CSF leak/risk 1 in 1700).

For best outcomes of this surgery the patient should not be smoking/stop smoking well before the surgery.

Endoscopic sinus surgery is most of the times a day case procedure and the patient goes home at the same day, without packs.

There is a routine treatment with antibiotics, steroid drops and possibly steroid tablets before and after surgery to improve outcomes. The patient can return to work in one to two weeks (depending on the profession). Nasal douching helps in the healing and prevents infection.