Consultant ENT, Head and Neck and Thyroid Surgeon

Functional Endoscopic Sinus Surgery (FESS)

Functional endoscopic (telescopic) sinus surgery is minimally invasive surgery through the nostrils using endoscopes and specially designed instruments including mechanical shavers and, if appropriate, special balloons to widen the sinus drainage channels (Balloon Sinoplasty)
  • individually tailored to the findings inside each patients nose and on a CT scan.

The operation is performed up inside the nose through the nostrils, under general anaesthetic. There are no scars on the face.
The aim of the operation is to open the sinus drainage channels and so restore the normal function of the nasal lining as far as is possible.
This is achieved by removing bone and inflamed lining in the narrow nooks and crannies of the sinus drainage pathways. These minute passages tend to stick together with long standing allergy or infection in the nose and sinuses, so blocking off the sinus drainage.
At the same time as this is carried out, any nasal polyps can be removed.

The surgery improves symptoms and helps prevent further sinus infections.
It is
successful in over 80% of patients.

Recovery and follow-up

• Your nose will feel slightly blocked for up to 2 weeks after surgery.

• Your nose may ooze slightly over the first 48 hours and occasional blood and crusts may appear from the nose or in the throat during this time. You should sneeze with your mouth open and avoid blowing your nose for 7 days.

• You may feel mildly unwell for a few days after the operation and will need 10 to 14 days off work, depending on the degree of physical activity associated with your work. You will be able to work at home after 7 days or so.

• Antibiotic and steroid tablets will be given to you after surgery to help the healing process.

• It is very important to douche your nose regularly with alkaline nasal solution for the first weeks after the operation. I would recommend you buy a nasal douching solution called Sinurinse by Neilmed. This is available from most larger local pharmacies or via the neilmed website. You can also make your own solution of salt water.


You will be seen in Outpatients approximately 2 to 4 weeks after surgery, and may need several further visits until the sinuses have healed.
On each occasion your nose and sinuses will be examined with a telescope. The inside of your nose can be numbed with an anaesthetic spray so it may be cleaned thoroughly.
This
aftercare is an extremely important part of the surgical procedure.

It will take the nose and sinus lining from between 6 weeks to 3 months to heal.

Complications

The sinuses are separated by very thin bone from the eye socket, tear duct and brain.
Damage to these structures has been reported in studies from Britain, USA and Europe, and research shows that the risk of a significant complication related to these areas is approximately 0.5 – 1%.

To date, I personally have had no such significant complications from this operation, but as part of a fully informed consent process I believe you should be specifically aware of these 4 particular possibilities, however unlikely they are.


-Bleeding
-Eye watering
-Visual change including double vision and blindness (1 in 8000)

-Cerebrospinal fluid leak (1 in 8000)

-Change in sense of smell including loss of smell (<1%)