Functional Endoscopic Sinus Surgery (FESS)

Definition: Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive surgical procedure used to treat chronic sinusitis and other sinus-related conditions. It involves the use of an endoscope—a thin, flexible tube with a light and camera—to view the sinus passages and guide the removal of blockages, polyps, or infected tissue, improving sinus drainage and function.


Purpose

The primary goals of FESS are:

  1. Restore normal drainage of the sinuses.
  2. Relieve symptoms of chronic sinusitis, such as nasal congestion, facial pain, and recurrent infections.
  3. Improve airflow through the nasal passages.
  4. Enhance the quality of life for patients with chronic sinus issues.

Indications

FESS is typically recommended for individuals who have:

  1. Chronic sinusitis that does not respond to medical treatments.
  2. Nasal polyps obstructing the sinus openings.
  3. Sinus infections causing complications such as abscesses or orbital cellulitis.
  4. Structural abnormalities like deviated septum or concha bullosa contributing to sinus blockages.
  5. Recurrent acute sinusitis impacting quality of life.

Procedure

FESS is performed under local or general anesthesia. The procedure generally involves:

  1. Preparation: The patient is prepped and anesthesia is administered to ensure comfort.
  2. Insertion of the Endoscope: The endoscope is inserted into the nostril to provide a magnified view of sinus passages.
  3. Removal of Blockages: Specialized instruments remove blockages such as polyps, scar tissue, or infected mucosa.
  4. Addressing Structural Issues: Structural abnormalities like deviated septum or enlarged turbinates may be corrected if needed.
  5. Ensuring Proper Drainage: All sinus pathways are checked to ensure proper mucus drainage.
  6. Conclusion: Instruments and endoscope are removed; nasal packing may be placed to control bleeding.

Recovery

Postoperative care includes:

  1. Resting with head elevated to reduce swelling.
  2. Avoiding strenuous activities, heavy lifting, and nose blowing for a few weeks.
  3. Using saline nasal sprays or rinses to aid healing.
  4. Taking prescribed medications like pain relievers, antibiotics, or nasal corticosteroids.
  5. Attending follow-up appointments to monitor healing and remove any nasal packing or splints.

Risks and Complications

Potential risks of FESS include:

  1. Infection
  2. Bleeding
  3. Adverse reaction to anesthesia
  4. Scarring or adhesions in the nasal passages
  5. Persistent symptoms or recurrence of sinus issues
  6. Rare injury to the eye or brain

Benefits

  1. Minimally Invasive: Less postoperative pain, reduced bleeding, and faster recovery.
  2. Improved Sinus Function: Relief from chronic sinus symptoms and better drainage.
  3. Enhanced Quality of Life: Improved sleep, reduced facial pain, and overall well-being.

Outcomes

When performed by an experienced ENT surgeon like Dr. Pooja Gullapalli, FESS has a high success rate. Most patients report significant improvements in sinus symptoms and quality of life, with long-lasting results.


Conclusion

Functional Endoscopic Sinus Surgery (FESS) is a vital surgical intervention for chronic sinusitis and sinus-related conditions. Dr. Pooja Gullapalli’s expertise ensures precise, effective, and safe treatment, improving breathing and overall quality of life.