What is FESS surgery?

What is functional endoscopic sinus surgery?

Functional endoscopic sinus surgery is a minimally invasive surgery. It is generally undertaken to bring aid from chronic rhinosinusitis that is not getting healed by antibiotics or other medications. 

Functional endoscopic sinus surgery is also known as endoscopic sinus surgery. Few health care providers term this entire process as ‘functional’ because the surgery is performed to revive how one’s sinuses work or function.

In this procedure of functional endoscopic sinus surgery, an ENT specialist uses nasal endoscopes which are thin tubes with lights and lenses to soothe one’s sinus symptoms without making incisions around the nose. 

Functional endoscopic sinus surgery can be initiated under local anesthesia or general anesthesia on an outpatient basis. The complexity rate for functional endoscopic surgery is lower than that of conventional sinus surgery. Also the patients typically experience minimal discomfort. 

Which conditions are treated by a functional endoscopic sinus surgery?

The following conditions are treated by a functional endoscopic sinus surgery:

What is FESS surgery? 1

Image courtesy – Wikimedia

What are the benefits of having a functional endoscopic surgery?

  • Relieves one from discomfort and pain
  • Stops other serious ailments such as meningitis or brain abscess
  • Elevates the sense of smell by improving airflow
  • A minimally invasive surgical procedure
  • Long-lasting results
  • Few surgical complications
  • Minor post-surgical bleeding
  • Less tissue removal

How is sinusitis diagnosed?

To diagnose sinus, the following methods are adopted by an ENT specialist:

  • Reviewing medical history
  • Doing a physical examination
  • Having tests like nasal endoscopy and CT scan done

The examinations help in identifying and assessing the middle turbinate, middle meatus, anatomic obstruction, mucopus and nasal polyps. On the basis of this, the ENT specialist recommends a functional endoscopic surgery.

The precautions which are needed to be taken prior to a functional endoscopic surgery are:

  • Abandon smoking at least three weeks prior to the surgery.
  • If the procedure involves general anesthesia, avoid drinking or eating post midnight on the day of surgery.
  • General anesthesia will be administered by the Anaesthetist shortly before the surgery begins.
  • The consumption of blood thinning medications like aspirin, ibuprofen, omega 3 or vitamin E should be stopped at least a week before the surgery.
  • If another medical condition requires prescribed blood thinners, then one must seek guidance from the ENT specialist about the stoppage and restarting of the medications.
  • All the medications prescribed by the ENT specialist need to be taken till the previous night of the surgery.
  • During checking in for surgery, carry any prescribed or non-prescribed medications which one is currently taking. 
  • Strictly avoid eating anything from midnight onwards prior to the surgery day.
  • The patient should be accompanied by an aide. 
  • It is recommended to bring along a close family member.
  • Ensure to report at the hospital at least three hours before the scheduled timing of the surgery.
  • Report at the reception desk in due time and the hospital staff will lead one through the next steps.
  • In case of any change in physical condition for instance cough, cold, fever or throat pain one should surely mention it to the ENT doctor and the anesthetist. 
  •  In case of allergic reactions to any drugs, make sure to strictly mention it. 

The procedure of a functional endoscopic surgery involves the following below mentioned steps which are performed by an ENT specialist:

  • They will put decongestant medication in one’s nose.
  • They will do a thorough follow-up nasal endoscopy.
  • Then they will inject a numbing solution into one’s nose.
  • With the help of an endoscope, they will gently enter one’s nose.
  • Followed by which, they will insert surgical tools alongside the endoscope.
  • Using the endoscope they will remove bone, diseased tissue or polyps that may be blocking one’s sinuses. 
  • They may also use a tiny rotating burr to scrape out tissue.
  • Once the procedure is done, they will pack one’s nose with material to absorb any blood or discharge.

Most functional endoscopic surgeries last for two hours. The recovery often takes 1 to 2 weeks.

Post the surgery one should take the following precautions as mentioned below to have a smooth recovery:

  • Restrain from blowing nose for a week
  • Sneeze with the mouth open
  • Blow out bloody discharge or mucus gently while sneezing
  • Avoid indulging in strenuous activities for the next 10 days 
  • Rinse the nose and sinuses with saline washes

The complications related to functional endoscopic surgery are:

  • Losing sense of smell
  • Watery eyes
  • Extremely heavy bleeding
  • Cerebrospinal fluid leakage
  • Difficulty in seeing

The risks associated with having a functional endoscopic surgery are:

  • Bleeding
  • Bad eyesight
  • Cerebrospinal fluid leak
  • Decreased sense of smell
  • Anesthesia risks
  • Septoplasty risks

What precautions are needed to be taken before a functional endoscopic surgery?

The benefits of undergoing an endoscopic dacryocystorhinostomy surgery can be summarized as:

  • Minimal pain which can be controlled using medications
  • Rate of infection is low after surgery
  • No facial scarring

Medically reviewed by SinusDoctor,
Dr G V K Chaitanya Rao

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