Description

Familiarity with Treatment

Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive surgical procedure used to treat chronic sinus conditions, such as chronic sinusitis and nasal polyps. It involves the use of an endoscope, a thin, flexible tube with a camera and light, to visualize and access the sinuses. FESS aims to improve sinus drainage, alleviate symptoms, and restore normal sinus function.

Procedure

The procedure for FESS typically involves the following steps:

1. Anesthesia: General or local anesthesia is administered to ensure the patient’s comfort during the procedure.
2. Endoscope Insertion: An endoscope is inserted into the nasal passages to provide a clear view of the sinuses.
3. Sinus Exploration and Treatment: The surgeon uses specialized instruments to remove or correct any obstructions, such as nasal polyps, inflamed tissue, or bony abnormalities, that may be blocking the sinus passages.
4. Sinus Drainage: The surgeon may enlarge the natural openings of the sinuses to improve drainage and promote better airflow.
5. Wound Closure: Once the necessary corrections are made, the incisions are typically left to heal naturally without the need for external sutures.

Who is it Suitable For?

FESS is most successful in patients who have recurrent acute or chronic infective sinusitis. Patients in whom the predominant symptoms are facial pain and nasal blockage usually respond well to FESS. The sense of smell often improves after this type of surgery.

Who is it Not Suitable For?

FESS may not be suitable for individuals with certain medical conditions that increase surgical risks or those who are unable to undergo the necessary postoperative care. A thorough evaluation by a healthcare provider is necessary to determine the suitability of the procedure for each individual.

Advantages

• Minimally Invasive: FESS is a minimally invasive procedure that is performed through the nostrils, avoiding the need for external incisions. This can result in less scarring, reduced pain, and faster recovery compared to traditional open surgery.
• Improved Sinus Drainage: The procedure aims to improve sinus drainage by removing obstructions and restoring the natural flow of mucus, which can alleviate symptoms and reduce the frequency of sinus infections.
• High Success Rate: Studies show that between 80% and 90% of people who have FESS for chronic sinusitis feel the surgery cured their problem. Even if it does not completely solve the sinus condition, FESS can significantly ease symptoms and limit the frequency of chronic sinus flares.

Complications

As with any surgical procedure, FESS carries potential risks and complications, although they are generally rare. These may include bleeding, infection, scarring, damage to surrounding structures, changes in smell or taste, and the need for revision surgery. Thorough preoperative analysis and surgical planning are essential for preventing complications.

Preoperative Care

Preoperative care for FESS may involve instructions to stop taking certain medications that can increase the risk of bleeding, such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). Patients may also be advised to avoid eating or drinking for a certain period before the surgery and to undergo a preoperative physical examination. Smoking cessation is often recommended before and after surgery to promote better healing.

Postoperative Care

Following FESS, patients are typically provided with specific postoperative care instructions, which may include:

• Nasal Irrigation: Regular nasal irrigation with saline solution to keep the nasal passages clean and promote healing.
• Pain Management: Medications to manage pain and discomfort as prescribed by the surgeon.
• Follow-up Appointments: Regular follow-up appointments with the surgeon to monitor healing progress, remove any packing or splints, and address any concerns or complications that may arise.

It is important for patients to closely follow the postoperative care instructions provided by their healthcare provider to ensure proper healing and optimal outcomes.

Functional Endoscopic Sinus Surgery is a widely used procedure for treating chronic sinus conditions. It offers the advantages of being minimally invasive, improving sinus drainage, and providing a high success rate.