Functional Endoscopic Sinus Surgery (FESS)

Explained in simple words

1FESS stands for Functional Endoscopic Sinus Surgery. It is an operation for long-standing sinus problems.

2The sinuses are hollow air spaces inside the bones of the face, around the nose, cheeks and forehead.

3They are lined with a thin skin that makes mucus, which normally drains into the nose through small openings.

4When those small openings get blocked, the mucus cannot drain. It collects inside and gets infected.

5This causes a heavy blocked nose, thick discharge, pain over the face, headache, and loss of smell.

6Many patients also complain of a bad taste, bad breath, snoring, or repeated throat infections from the discharge dripping backwards.

7The first treatment is always medicines — antibiotics, nasal sprays and washes. Surgery is advised only when medicines have been given a fair trial and have not worked.

8In FESS, the surgeon uses a thin telescope called an endoscope, which is passed through the nostril.

9The telescope carries light and shows a magnified picture of the inside of the nose on a television screen.

10Working while watching the screen, the surgeon opens up the blocked drainage passages of the sinuses.

11The word "functional" is important. The aim is not to remove the sinuses, but to restore their natural function of draining freely.

12Only the diseased tissue and the blockage are removed. Healthy tissue is preserved.

13Because everything is done through the nostril, there is no cut on the face and no external scar at all.

14Polyps, which are soft grape-like swellings in the nose, can also be removed in the same operation.

15A deviated nasal septum, that is a bent partition inside the nose, can be straightened at the same time if needed.

16The operation is usually done under general anaesthesia and takes about one to two hours.

17Most patients go home the same day or after one night in hospital.

18After surgery the nose may feel blocked for a week or two, because of swelling and crusting. This is normal and settles.

19You will be given saline nasal washes. Doing them regularly is the single most important thing for a good result.

20Avoid blowing the nose forcefully, heavy exercise, swimming and dusty places for a few weeks.

21You will be asked to come for cleaning of the nose once or twice after surgery. This helps healing and prevents blockage from re-forming.

22Most patients breathe much more freely, get fewer infections, and often recover their sense of smell.

23For patients with allergy or asthma, medicines usually need to be continued after surgery to keep the sinuses healthy in the long run.