Functional endoscopic sinus surgery (FESS)

The majority of patients with sinusitis do not require surgery. However, in some patients with chronic sinusitis, the symptoms continue despite prolonged medical treatment. Surgery should only be considered when medicines have failed to improve the patient's symptoms and quality of life. The most common indications for surgery include chronic bacterial infection, nasal obstruction or blockage, and nasal polyps.

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Functional endoscopic sinus surgery (FESS) has become the standard technique for sinus surgery. In carefully chosen patients, research has found FESS to be 70 to 90 percent successful in improving symptoms of sinusitis and related nasal and sinus problems. During the operation, the surgeon will enlarge the openings of the sinuses, allowing them to drain more easily. The surgeon may also remove diseased tissue and nasal polyps.

While older sinus surgery techniques included making incisions in the face, FESS is a minimally-invasive approach in which the surgeon uses an endoscope to view the important structures of the nose and sinuses. The endoscope is inserted through the nose, as are the tiny surgical instruments the surgeon uses to perform the surgery. The view with the endoscope allows for better identification of the underlying disease, which in turn allows the surgeon to be precise, careful, and thorough with minimal damage to normal surrounding tissue. FESS allows for less tissue removal, more rapid tissue healing, and shorter recovery periods. The surgery is often performed on an outpatient basis. It may be performed with general anesthesia or local anesthesia with sedation.

As with any surgical procedure, FESS has associated risks. Although the chance of a complication occurring is small, it is important that you understand the potential complications and ask your surgeon about any concerns you may have.

Although FESS is the most commonly performed surgery for sinusitis, in some cases other surgical procedures may also be necessary, such as surgery to remove the adenoids or open surgery on the forehead to reach the pair of sinuses located above the eyes.

This section includes information on risks of FESS.