Endoscopic sinus surgery, sometimes called functional endoscopic sinus surgery (FESS) is a minimally invasive procedure to treat problems in the sinuses.
The most common sinus surgeries are minimally invasive and often provide immediate relief from sinus pressure and pain while curing sinus infections.
In the presence of a sinus infection, there is a small risk of developing a more complicated infection like an abscess or meningitis. All operations in the sinuses and nose carry a rare chance (about 0.1%) of creating a leak of cerebrospinal fluid (CSF).
Functional endoscopic sinus surgery (FESS) is minimally invasive surgery for serious sinus conditions. Healthcare providers use nasal endoscopes — thin tubes with lights and lens — to ease your sinus symptoms without making incisions in or around your nose.
Endoscopic sinus surgery typically takes about two hours and does not require an overnight hospital stay. There is no swelling or bruising of the face as a result of surgery.
You will probably be able to return to work or school in about 1 week and to your normal routine in about 3 weeks. But this varies with your job and the extent of your surgery. Most people feel normal in 1 to 2 months.
Pain: You should expect some nasal and sinus pressure and pain for the first several days after surgery. This may feel like a sinus infection or a dull ache in your sinuses. Extra-strength acetaminophen should relieve mild discomfort. Avoid aspirin and NSAIDs such as ibuprofen or naproxen.
Outcome. The results after FESS are good, with most studies reporting an 80 to 90 percent rate of success. Good results also have been obtained in patients who have had previous sinus surgery.
Sleeping: Please sleep with the head on two elevated pillows to decrease nasal congestion and bleeding from the nose. If you have been prescribed a CPAP machine, do not use until your doctor says it is safe; sleep in a recliner chair with your head elevated in the meantime.
Each year about 250,000 – 300,000 people have sinus surgery performed to treat nose and sinus complaints.
Orbital involvement in endoscopic sinus surgery occurs in 0.5%64 to 3% of all procedures, and represents 16% to 50% of all complications. Most common risks encountered in endoscopic sinus surgery include bleeding, infection, injury to the eye and its adnexa, cerebrospinal fluid leak, anosmia etc.
You may have some pain and bleeding for 2 weeks after surgery. You could have less sense of smell after surgery. Serious but rare risks can include heavy bleeding, meningitis, and brain injury.
You may have symptoms like a severe cold or a sinus infection. This is due to swelling, dry blood, mucus, and crusting in your nose. To help your nose and sinuses return to normal, your doctor may recommend nasal irrigation or saline sprays and antibiotic lubricants.
You might need surgery if you have badly damaged sinus tissue, benign growths (called polyps), a fungal infection or structural problems that are preventing your sinuses from draining.
A breathing tube will then be placed through the mouth. During surgery the patient will be kept completely asleep by breathing gas through this tube under the supervision of an anesthesiologist. Heart rhythm, blood pressure and oxygen levels will be closely monitored throughout the operation.
Right after surgery, you will have drainage from your nose. At first, there may be a small amount of bright red bleeding, but do not be alarmed. A small amount is normal and may continue through the first week.
Light walking and regular household activities are acceptable anytime after surgery. You may resume exercise at 50% intensity after one week and at full intensity after two weeks. You should plan on taking one week off from work and ideally have a half-day planned for your first day back.
Sneezing can cause further trauma to the fragile, yet sensitive nose and compromise the procedure's results. If possible, avoid sneezing through your nose for the first week or two during recovery to reduce pressure in your nose and airways to keep the sutures intact and minimize bleeding, swelling, and pain.
Following a functional endoscopic surgery, patients can breathe easier and will notice significantly reduced sinusitis symptoms. A procedure involving the insertion of a tiny inflatable balloon into the sinus passages balloon sinuplasty widens nasal airways to improve breathing as well.
Sinus issues can be persistent. As such, it is very common for them to return – even after surgical intervention.
Functional endoscopic sinus surgery (FESS) procedures are outpatient or day surgery, which means the patient can usually go home the same day as the procedure.
You may have some bruises around your nose and eyes. Your nose may be sore and will bleed. This may last for several days after surgery. The tip of your nose and your upper lip and gums may be numb.
Because surgery clears the airways and restores normal sinus and nasal drainage, decongestants and steroid nasal sprays are more effective at soothing symptoms when administered post-operatively. Also, sometimes surgery doesn't cure sinusitis, but it does make breathing easier.
Performed over 200,000 times annually in the United States to treat medically refractory sinusitis, FESS has success rates as high as 98%. When surgical failure occurs, it is typically due to postoperative scarring or unaddressed outflow tract obstruction in the region of the frontal recess.