Functional Endoscopic Sinus Surgery
Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive surgery for diseases of the nasal cavity and sinuses. This means the surgery is made without making any cuts in or around the nose. The surgery is performed with a camera and small surgical tools that fit in the nose. Typically, it is performed to remove any disease (for example nasal polyps) from the nose and to widen the openings into the sinuses. Usually, it is done once a patient fails medical therapy (such as nasal steroid sprays).
The goals of sinus surgery include:- Reduce the number and severity of sinus infections- Improve sinusitis symptoms- Improve the drainage of the sinuses- Improve airflow through the nose- Allow access for nasal rinses to reach the sinus cavities for cleaning and medicationdelivery
What happens before the procedure?Every person’s situation is different, but often the following is recommended:1. Continue using your nasal steroid sprays and rinses as prescribed up to the day of surgery2. You may be prescribed antibiotics and an oral steroid to take before the surgery. Take this as prescribed as it is important in decreasing any inflammation in your nose which results in less blood loss during the surgery3. Do not use any decongestant medication. Using this regularly may result in your surgery being canceled
The hospital surgical team will contact you to perform a preadmission assessment and provide you with instructions on what medications to hold, timing of not eating or drinking before your procedure, and when and where to go.
How long does the surgery take?The surgery takes between 1-2 hours. You will be asleep under general anesthesia during the surgery. Unless you have untreated sleep apnea, or a medical condition requiring admission, most patients are discharged home the same day. Most patients do not require nasal packing that needs to be removed.
What kind of recovery can I expect?Often you will require 1-2 weeks off of work. No heavy lifting (over 10 kg) or strenuous activity is permitted for 2 weeks after surgery. You should also avoid nose-blowing for at least 1 week after surgery and sneeze with your mouth open. A moderate amount of pain is possible – often described as a headache. Often ibuprofen and acetaminophen can control this pain but you will also be prescribed additional pain control medications if needed. Although there is rarely any bruising or swelling on the face, the inside of the nose will be swollen and sore. It is common to have nasal congestion and discharge for the first few weeks after surgery because of this. Bleeding for the first few days after surgery is possible and common. If it does not stop quickly or is quite heavy, you may need to return to hospital for further management. After surgery, you should start rinsing your nose with a saline rinse (e.g. Neilmed) and should resume your nasal steroid spray in one week. Although you can resume your regular activities within 2 weeks, full healing can take months.
What are the risks?All surgeries come with potential complications and risks. Your physician will discuss these in greater detail, but a few you may experience include:1. Losing you sense of smell or not gaining it back if it is already lost2. Unusually heavy bleeding3. Leaking of cerebral spinal fluid – this is a rare complication and a leak could lead to the development of meningitis4. Problems seeing – this is another rare complication that can result in double vision or rarely blindness5. Infection6. Numbness to the teeth or roof of your mouth