If you’re suffering from chronic sinusitis and have exhausted all medical treatment options, your doctor may recommend a surgical procedure known as functional endoscopic sinus surgery (FESS). This minimally invasive operation is designed to improve the functioning of the nose. It is performed through an endoscope, which is a small camera and light that allows your surgeon to see easily inside the nose. FESS is done on the sinuses, which are small bony channels and openings that extend from the inside of the nose to the forehead, cheeks, and between the eyes.
What Is Sinusitis?
Sinusitis is a common condition where the tissues that line the sinuses become swollen and inflamed. This traps fluid inside and promotes germ growth, causing an infection. Many factors can cause sinusitis including nasal polyps, deviated septum, respiratory tract infections, allergies, foreign objects in the nose and additional medical conditions.
Chronic sinusitis results in a variety of cold-like conditions including congestion, runny nose, facial pain and pressure, loss of smell, fever, fatigue and dental pain. It is considered chronic when symptoms last eight weeks or longer.
Treatment for chronic sinusitis involves medications such as decongestants, antihistamines, nasal sprays, oral steroids and antibiotics. Home remedies – using a humidifier, inhaling hot steam, a warm compress – often help relieve pain and discomfort. Sometimes, these treatments aren’t enough to clear up chronic infections. In those instances, your doctor might turn to surgery.
What Is FESS?
The goal of FESS is to open up the sinuses, allowing normal drainage of fluids to occur. Without proper ventilation, mucus builds up in the sinuses, leading to infection.
Potential candidates for FESS are evaluated based upon their history, a physical exam, and CT scan. Please remember that at your initial visit, it is important to bring records from any doctors you visited previously, including:
- Your medical history
- Up-to-date information on any course of treatment
- A list of medications you have been and/or are currently taking
- Any previous CT or MRI scans, if they are available. A CT scan helps the ENT surgeon accurately assess the areas involved. If you do not have a CT scan, one may be scheduled. These CT scans may be done in-office utilizing our special, low-radiation CT scanner.
If the odds of a successful surgery look promising, an appointment will be scheduled with a surgeon at Raleigh Capitol Ear, Nose & Throat. However, before surgery is considered, your ENT physician may try additional medical therapy before deciding to do a surgical procedure. If your physician believes you would benefit from endoscopic sinus surgery, he or she will discuss the procedure with you and will arrange a date for the surgery.
What To Expect During the Procedure
FESS is usually performed as an outpatient procedure under local anesthesia. An endoscope is inserted in the nose, and the camera is used to visually inspect the sinus openings. The surgeon relies on these images to remove excess obstructive tissue. The surgery is performed through the nostrils, making it a less intrusive procedure that won’t leave scars or cause facial swelling or bruising. Post-operative care includes flushing the nasal passages to keep debris from building up. In some cases, antibiotics or steroids may be prescribed to speed up the recovery process.