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Functional Endoscopic Sinus Surgery: Purpose, Procedure, and Benefits and Side Effects

Last Updated: Jul 06, 2023

What is Functional Endoscopic Sinus Surgery (FESS)?

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Functional endoscopic sinus surgery (FESS) can be defined as a minimally invasive surgical procedure that is basically carried out to treat serious sinus (infection) conditions.

It must be mentioned that this procedure has recently emerged as a popular option to treat sinus problems. It is usually conducted through a patient's nasal passage.n

Sinusitis is a common medical condition and can cause a variety of symptoms, ranging from an excruciating headache to a cough. It can also cause severe pain and intolerable pressure in your face. Although it is a common ailment, many people don't know much about it, and the symptoms of sinusitis can be confused with other types of conditions.n

Sinusitis is not just a minor infection. It is a medical condition that can seriously affect your quality of life. Hence, this condition should never be ignored or left unmonitored.nSinusitis can also be considered a long-lasting inflammation caused by the swelling of your sinus cavities. Sinuses are located near the nasal passages.n

A sinus is a major nasal passage that connects the nose and the pharynx. It is located behind the eyes, cheeks, and forehead. Sinuses are interconnected with each other and with the nose. n

There are important cavities in the sinuses called the paranasal sinuses. These sinuses are connected to the nose and drain into the nose. Sinuses help to moisten, warm, and filter the air that we breathe in.n

The swelling of sinuses often gives rise to inflammation in the nasal passages of a person, which eventually results in the symptoms of sinusitis. One of the best and most effective methods for treating sinusitis is functional endoscopic sinus surgery (FESS).

Types of Functional Endoscopic Sinus Surgery

It must be noted that functional endoscopic sinus surgery (FESS) is one of a kind and involves a specific method. However, there are certain other surgical procedures that may be put to use by healthcare providers to treat sinus problems. These procedures include septoplasty, turbinate surgery, adenoidectomy, and balloon sinus dilation (among others).

Benefits of Functional Endoscopic Sinus Surgery

  • Minimally invasive surgery
  • Minimal pain
  • Long-lasting results
  • Less dependence on medication
  • Increased visibility (in some cases)
  • Solution to breathing issues
  • Few (or rare) surgical complications
  • No outward scarring (of the nose)
  • Less tissue removal
  • Little post-surgical bleeding
  • Speedy (or fast) recovery

Why is Functional Endoscopic Sinus Surgery Done?

Functional endoscopic sinus surgery (FESS) can be called a standard treatment procedure for chronic sinus problems that prevent you from breathing with ease. Healthcare providers or surgeons carry out this surgery in order to treat chronic sinusitis by removing nasal polyps.

A sinus infection can be extremely painful and debilitating, with symptoms of congestion, sinus pain and pressure, pain, fatigue, and even fever. This form of infection is common, affecting millions of people each year. Unfortunately, the medicines used to treat sinus infections are often ineffective, and the infection may become chronic, resulting in a debilitating condition called sinusitis.

Sinus problems might not be the most alarming of health problems, and the symptoms might come and go. That is why people don't pay much attention to it until the problem gets bad enough to affect their lives. If that happens, you must see a doctor and get treated as soon as possible. Typically, doctors will advise you to have this kind of surgery.

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What Are the Risks of Functional Endoscopic Sinus Surgery?

  • Significant or excessive bleeding may sometimes require termination of the procedure
  • Visual loss owing to injury to the optic nerve or eye (very rare)Issues like double vision may be caused by injury to the muscles of the patient's eye during the procedureAnother possible complication is persistent or constant tearing (dripping) of the eye

How Do I Prepare for Functional Endoscopic Sinus Surgery?

You must know that certain medications can increase your risk of (excessive) bleeding during or after functional endoscopic sinus surgery (FESS). These medications may include NSAIDs and aspirin, among others. Such medications should be stopped (on a doctor's consultation) at least a couple of weeks prior to FESS.

Certain types of vitamin E as well as herbal medicines may also increase the risk of bleeding. They should also be stopped by the patient for a few days prior to their surgery. A person who is going to have functional endoscopic sinus surgery should also stop smoking a few days beforehand, as regular or continued smoking can severely affect the final outcome of FESS.

How Is Functional Endoscopic Sinus Surgery Done?

FESS is a minimally invasive method that is predominantly put to use by healthcare providers in order to restore sinus ventilation and normal respiration. The best or most eligible candidates for this procedure may be those who suffer from chronic or recurrent acute infective sinusitis. It must be noted that an improvement in symptoms of up to 90% is possible after this surgical procedure.

Doctors use fiber optic telescopes for the diagnosis of sinus infections and computed tomography in order to assess the anatomy and identify the affected or diseased areas. Functional endoscopic sinus surgery has to be reserved for patients for whom other medical treatments or remedies have failed to work.

The surgical procedure (FESS) can be carried out under the influence of local or general anesthesia, and it is usually done on an outpatient basis. Patients, in most cases, experience minimal pain or discomfort. This minimally invasive surgical procedure is much safer than other conventional surgeries.

The procedure involves the doctor or surgeon injecting a numbing solution into the patient's nose. Then an endoscope is used to gently enter the patient's nose. Alongside the endoscope, surgical tools are also inserted into the nose.

Thereafter, the affected bones, polyps, or diseased tissue that are blocking the patient's sinuses are removed. The surgical team can also scrape out tissue with the help of a small rotating burr.

Before the Procedure

  • Take ample time off from work
  • Avoid smoking for a few weeks before the procedure
  • Keep your doctor informed about the medications you take
  • Speak with your doctor about the procedure and its dos and don'ts
  • Start fasting after midnight prior to the surgery (on your doctor's advice)

During the Procedure

  • The healthcare provider or ENT surgeon puts decongestant medication into the patient's nose
  • A follow-up nasal endoscopy is done
  • A numbing solution is injected into the patient's nose
  • The endoscope is used to gently enter the patient's nose
  • Surgical tools are inserted alongside the endoscope in order to remove the diseased tissue, affected bone, or polyps
  • A small rotating burr may also be used to scrape out the diseased tissue
  • In the end, the surgeon may pack the patient's nose with a material that can absorb any discharge or blood

After the Procedure

After the FESS procedure, the patient will most likely spend some time in a recovery room so that the healthcare provider can easily monitor their condition. The patient won't be able to drive back to their home after surgery, so they must have someone to take them home. The patient should also have a friend or family member stay with them the first night following their surgery.

Apart from all this, the healthcare provider or doctor will tell their patient what they can expect after the surgical procedure is done. Here is some more general information:

  • The patient may be asked not to blow their nose for at least seven days after the procedure
  • If the patient needs to sneeze, they must keep their mouth open or sneeze into a tissue or something similar
  • Bloody discharge or mucus might be blown out while sneezing after the surgery until complete recovery
  • Avoid indulging in any strenuous activity for at least a week after the procedure
  • The patient may be advised to rinse their sinuses and nose with saline

How Much Does Functional Endoscopic Sinus Surgery Cost?

The average cost of FESS, or functional endoscopic sinus surgery, in Indian hospitals might range somewhere between Rs. 40,000 and Rs. 65,000.

However, this cost is merely for reference purposes and should not be considered a standard cost. The best thing you can do in this regard is to get in touch with our team of experts and get the precise cost of functional endoscopic sinus surgery (FESS) in India.

What to Do After Functional Endoscopic Sinus Surgery?

  • Avoid blowing your nose for several days after the procedure
  • Always remember to use a tissue or handkerchief while sneezing
  • Do not panic if you blow out bloody discharge while sneezing in the days after the surgery
  • Any strenuous task or activity should be avoided for several days, maybe weeks
  • Use saline to rinse your sinuses or nose (with your doctor's permission)

Is Functional Endoscopic Sinus Surgery Safe?

Functional endoscopic sinus surgery (FESS) has nowadays become one of the most common surgeries in the world. This surgery is considered extremely safe as well as effective.

Like in any other surgical operation, there are some risks involved, even in FESS. However, the chance of complications or risk is extremely low. Moreover, blood loss in small quantities is quite normal during this surgical procedure. Rarely, there is a risk of excessive or significant loss of blood.

Is Functional Endoscopic Sinus Surgery Painful?

The patient should expect some nasal and sinus pain or pressure for the first several days following the surgical procedure (FESS). This pain or discomfort may feel like a typical sinus infection or a kind of dull, incessant ache in your sinuses. Having said that, certain painkillers and anti-inflammatory drugs are often all that is needed by the patient for mild post-operative pain or uneasiness.

How Long Does It Take to Recover from Functional Endoscopic Sinus Surgery?

It can take several days, or even months in some cases, to completely recover from functional endoscopic sinus surgery (FESS). It may require ample time before you can feel as if you are back to your normal life and routine.

In most cases, people may return to school or work in just a week or so. Other people (or patients) may take longer to get back to their normal routine or everyday activities.

What Are the Side Effects of Functional Endoscopic Sinus Surgery?

  • Excessive blood loss
  • Bleeding even after the surgical procedure
  • Intracranial complications
  • Damage to the optic nerve or surrounding tissue
  • Changed voice (rare)
  • Loss of taste or smell after the surgery
  • Failure to resolve the condition
  • Nasal issues
  • infection
  • Pain

Note: All the above-mentioned side effects can be greatly minimized or even eliminated if the surgery is carried out by expert doctors or surgeons, such as those available at Pristyn Care.

Functional Endoscopic Sinus Surgery Aftercare:

You must avoid any kind of exposure to chemicals, sawdust, or excessive dust for at least four weeks after the surgical procedure. Your doctor will advise you to avoid indulging in any strenuous activities, including jogging, biking, weight lifting, or aerobic exercises, for at least a week after the surgery.

The doctor will most likely ask you to ease back into your routine activities over the next two to three weeks. Besides all that, you may be allowed to drive when you are no longer taking any pain medicines prescribed by your healthcare provider and feel comfortable driving. Some other steps that may be taken to speed up your recovery process after functional endoscopic sinus surgery are as follows:

  • Eating healthful and nutritious foods
  • Sleeping well
  • Taking ample rest
  • Being positive
  • Keeping calm and having patience

Conclusion

Sinusitis, also known as inflammation of the sinuses, can be a problematic condition for a lot of people. It is highly recommended to consult with a specialist before making any major decisions related to this delicate procedure.

Physicians who specialize in maxillofacial surgery are the main specialists who perform this particular procedure. We are glad to inform you that you can conveniently find such specialists at Pristyn Care.

References

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Written ByDr. Gladson Guddappa Uchil MBBS,Diploma in Otorhinolaryngology (DLO),Diploma In Otorhinolaryngology (DLO)Ear-Nose-Throat (ENT)
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