Functional Endoscopic Sinus Surgery (FESS)
What is FESS?
FESS is a keyhole procedure, done through the nostrils, for treating chronic sinus infection (chronic sinusitis) or nasal polyposis. The patient is under general anaesthetic (fully asleep) and the surgeon uses rigid endoscopes and CT scans to perform the surgery.
The rigid nasal endoscope is a small rod-like instrument with a light on the end, 4 millimetres or less in diameter. With a range of lenses to see around corners, and a powerful fibreoptic light source, the surgeon gets close-up views of the internal nose and sinuses. Using specially designed instruments and powered suction debriders, the sinus openings will be enlarged and anything blocking the sinuses, such as swollen mucosa or polyps, will be removed. Occasionally other procedures such as septoplasty and inferior turbinate reduction are done at the same time as FESS.
What is the aim of FESS?
The aim of FESS is to clear the blocked outflow tracts of the sinuses allowing aeration and recovery of the sinuses in chronic sinus infection and remove nasal polyps.
What are the possible complications of FESS ?
FESS is generally very safe in modern medical practice but it is not totally risk free. There is a small risk of damage to the surrounding structures, including the eyes and the brain. There is a risk of excessive bleeding, either during or up to two weeks after the operation.
What is the success rate of FESS?
About 90% of patients get great relief of their symptoms and are satisfied with the results of FESS. It works very well for patients with blockage of the nose, facial pain or headache due to chronic sinusitis. The results are not as good for postnasal drip – only about 50% of these patients experience improvement. If there are polyps present, they may recur in up to 50% of patients.
Computer assisted surgical navigation in FESS is a relatively new tool used in select cases. These devices provide information on the anatomic location of instruments within the sinuses during surgery using CT scan images.