Functional Endoscopic Sinus Surgery (FESS)
Relief for Sinus Infections and Sinusitis
What is FESS?
Sinus surgery used to be invasive and painful. No more. Fiberoptic endoscopes and computed tomographic (CT) scanning have revolutionized the process, lessening discomfort, recovery time, and any associated risks. Often accomplished in an outpatient procedure with local anesthetic, functional endoscopic surgery provides relief from sinus infections and sinusitis by removing any diseased or obstructive tissue. The doctor performing sinus surgery uses a fiberoptic endoscope to view the sinuses, and so can see and remove just the tissue causing the problem. This minimal removal of tissue, plus the fact that the endoscope and other instruments are passed through the nose, means reduced discomfort and faster healing.
What Type of Sinus Surgery is Best for You?
Though FESS is much less invasive than older traditional procedures, alternatives to sinus surgery should always be considered first. A few things to consider:
Acute vs. chronic sinusitis: Acute sinusitis typically lasts 30 days or less and is most often caused by a virus, and sometimes by bacteria or fungi. It will usually go away on its own, though over-the-counter treatments and medications may relieve symptoms. Chronic sinusitis lasts more than 90 days and/or recurs often. It’s typified by persistent inflammation, and relief usually requires intervention, either medical therapy (like steroids) or a surgical procedure.
Balloon sinuplasty vs. endoscopic sinus surgery: Dr. Kayem advises that chronic sinusitis patients consider an even more minimally invasive sinus surgery first: balloon sinuplasty. This cutting-edge FDA-approved treatment requires no cutting and has a 90% success rate. Learn more here.
Both types of sinus surgery are typically covered by insurance.
Functional Endoscopic Sinus Surgery: What to Expect
When you see Dr. Kayem about sinusitis or sinus infections, you’ll first be given a thorough evaluation that includes a physical exam, a nasal endoscopy, and a review of your medical history. He typically recommends the least invasive course first (medical therapy or balloon sinuplasty), but if those treatments have failed to correct the issue, he’ll ask you to get any necessary preoperative tests, which usually include a CT scan, before scheduling surgery.
Pre-sinus surgery, the doctor will give you instructions regarding medications, smoking, and fasting. Your surgery will be performed under anesthesia (often local) and is usually not uncomfortable. Traditional absorbent nasal packing (which was uncomfortable to remove) is no longer used. Instead, Dr. Kayem will use resorbable material, or none at all.
You will need to avoid blowing your nose for a few weeks (during which time there may some discharge) and return for post-operative visits to ensure healing is on track. During these visits, Dr. Kayem will clean the surgical cavity, remove any unnecessary scar tissue, and consider whether medical therapy should be continued.
Postoperative recovery can be uncomfortable and may take a few weeks, but most patients are happy they had surgery. FESS has an 80-90% success rate, and can provide relief from pain, easier breathing through the nose, and even an improved sense of smell.