What is functional endoscopic sinus surgery (FESS)?
Functional endoscopy sinus surgery is a minimally invasive technique for sinus surgery. The entire procedure is conducted using cameras, called scopes, and performed within the nose. Technology has progressed significantly since it was first introduced in the 1990s, now allowing for the safe surgical treatment of many nasal and sinus issues. A major advantage of this technique is that even complicated disease processes can be treated as same day surgery, allowing patients to go home directly after the surgery has been completed.
![sinus-surgery-equipment]()
Endoscopic surgery requires use of a small camera and long instruments, allowing the entire procedure to be performed inside the nose without requiring any external incisions.
What is image guided sinus surgery?
When you undergo a CT scan prior to your surgery, the images will then be used for navigation during your surgery. Advances in technology have enabled GPS-like tracking of the instruments used during the procedure that can help in navigating through tricky aspects of your anatomy. This becomes important when treating disease processes near the brain or eye.
I already had sinus surgery, why do I need revision sinus surgery?
- Nasal polyps
One of the most common causes for revision sinus surgery is nasal polyps. Nasal polyps, unlike polyps in your GI tract, are benign and are produced in response to chronic inflammation within the nose. Unfortunately, the root cause of this inflammation is not treatable with surgery and therefore the polyps can return in time. The key to delaying the growth of nasal polyps is having an understanding of the underlying mechanism of inflammation and directing treatment accordingly.
Surgery of the sinuses allows for clearing polyps and infection for immediate symptom relief, and allows for more space within the nose for your medication to work. Studies have shown that the earlier that patients with chronic sinusitis undergo surgery, the better their outcomes are in the long term. This is because long-term inflammation can lead to permanent damage to the lining of the nose and sinuses.
A subset of patients may benefit from non-surgical procedures, including the placement of steroid releasing nasal implants. These can help keep inflammation in check and delay the time to require surgery.
- Incomplete previous surgery
Another common cause for repeat sinus surgery is in patients that underwent an incomplete initial surgery. Although these first surgeries often proceed without any issues, many of these patients still complain of persistent symptoms. There are many small honeycomb-like sinuses throughout your nasal passages, and if any diseased tissue is left behind, it may scar and cause further problems. For this reason, it is vital that the first surgery is as thorough as possible to ensure excellent outcomes.
What is the recovery like for sinus surgery?
Functional endoscopic sinus surgery is one of the more easily tolerated procedures in the field of Otolaryngology. Most patients only require over the counter pain medicine, and will usually be ready to return to their normal activities after about 1 week. After surgery, patients will return to clinic for cleaning of crusts and debris within the nose to help ensure that healing progresses with less scar formation. During the recovery period, it is very important that regular saline rinses and prescribed medications are used in order to make sure that the nose and sinuses remain clean, and that any underlying inflammation is kept at a minimum during the healing process.
What is balloon sinuplasty?
Balloon sinuplasty is a type of sinus surgery that can be offered to a select group of patients whom do not qualify for major surgery, but would still benefit from improving the openings into the sinus cavities. If a particular group of sinuses are blocked, or if you are experiencing abnormal sinus pressure, balloon sinuplasty may be an excellent option if medication has failed. A wire containing a balloon is passed into the problematic sinus cavities and inflated open, causing micro-factures of the bone of the sinus canals, resulting in immediate relief. This procedure can be performed in the office setting, without the need for general anesthesia or the operating room.
