Understanding FESS Surgery
Functional Endoscopic Sinus Surgery (FESS) is a common procedure aimed at improving sinus function. It is a minimally invasive technique that allows surgeons to address issues within the nasal passages without external incisions. The primary goal of FESS is to restore proper drainage and airflow within the sinuses, which can become blocked or inflamed due to various conditions.
This procedure utilizes an endoscope, a thin, rigid tube equipped with a camera and light, to provide a magnified view of the internal structures. The endoscope is inserted through the nostrils, enabling the surgeon to visualize the nasal passages and sinuses on a monitor. This approach distinguishes FESS from older, more invasive methods requiring external cuts.
Conditions Treated by FESS
FESS is typically recommended for individuals experiencing chronic sinus issues that have not responded to conventional medical treatments, such as antibiotics or nasal sprays. The most common condition addressed by FESS is chronic rhinosinusitis, which involves persistent inflammation of the nose and sinuses lasting longer than 12 weeks. This inflammation can lead to symptoms like congestion, facial pain, and difficulty breathing.
Nasal polyps, which are noncancerous, grape-like growths in the nasal passages or sinuses, also frequently necessitate FESS. These polyps can obstruct normal sinus drainage and airflow, contributing to chronic symptoms. Other structural abnormalities, such as a deviated septum or enlarged turbinates, may also be addressed during FESS to improve overall sinus function and alleviate symptoms.
The FESS Surgical Process
The FESS procedure is performed under general anesthesia, ensuring the patient is asleep and experiences no pain during the surgery. Before the endoscope is inserted, decongestant medicine may be applied to the nose to help clear the sinus passages. A numbing solution might also be injected into the nasal area.
The surgeon then carefully inserts the endoscope through the nostril to navigate and visualize the sinus tissues. Specialized instruments are used alongside the endoscope to precisely remove any tissue, bone, or polyps that are causing blockages or impeding drainage. This often involves widening the natural openings of the sinuses, such as the maxillary, ethmoid, or frontal sinuses, to improve ventilation and drainage.
This precision helps to preserve healthy tissue while effectively clearing obstructions. The duration of the procedure can vary, but most functional endoscopic sinus surgeries typically last about two to three hours if both sides are involved.
Recovery and Aftercare
Following FESS, patients can expect some common post-operative experiences as the sinuses heal. Minor bleeding, pain, congestion, and discharge are normal for the first few days to a week after surgery. A drip pad may be placed under the nose to collect any drainage.
Nasal saline rinses are an important part of aftercare, helping to moisturize the nasal passages and clear out any crusting or debris. Patients are typically advised to avoid blowing their nose forcefully for about two weeks and to sneeze with their mouth open to minimize pressure. Strenuous activities and heavy lifting should also be avoided for at least one to two weeks to aid healing.
Regular follow-up appointments with the surgeon are important to monitor the healing process and remove any remaining crusts or scar tissue. While some discomfort and congestion may persist for a few weeks, most patients can return to their normal routines within one to three weeks, though full recovery can take a few months.
Potential Complications and Considerations
While FESS is generally considered a safe and effective procedure, as with any surgery, there are potential risks. The most common complications include bleeding and infection, though these are typically mild and manageable. Serious bleeding is rare, occurring in approximately 3 out of every 100 surgeries.
Other potential, though less common, complications can include changes in the sense of smell, which may be temporary or, in rare instances, permanent. More serious complications, such as injury to the eye or structures near the brain, are extremely rare due to the precise nature of the endoscopic technique and the surgeon’s detailed knowledge of nasal anatomy. Surgeons will discuss these potential considerations in detail with patients before the procedure.