Functional Endoscopic Sinus Surgery (FESS)


For patients suffering from recurrent or chronic sinusitis that fails to respond adequately to medical management, sinus surgery can offer substantial relief. While an important part of the management of chronic sinus disease, surgery should not be seen as a stand-alone cure. Continued medical therapy remains an important part of successful long term management. This is especially true in patients with more severe disease of the mucus membranes or nasal polyps.

Goals of surgery may include:

1) Improved drainage of the sinus cavities.

2) Improved ventilation of the sinus cavities and airflow through the nose.

3) Improved access of topical medications and rinses to the sinus lining (mucosa).

Sinus surgery is not a "one size fits all" treatment. The surgical approach and extent varies based on the individual patient's anatomy as well as which of the above goals are most important. For example, patients with recurring sinus infections and a defined anatomical blockage may simply need a very minimal procedure to resolve the blockage, while a patient with severe mucosal disease and polyps would benefit most from a more aggressive procedure, widely opening the sinuses to optimize topical medication delivery.

During surgery, small endoscopes are inserted into the nose to visualize the sinus passages. Small instruments are used to remove tissue around the natural openings of the sinuses to enlarge these openings. Depending on the extent of surgery needed, this may be performed either in an operating room under general anesthesia, or in the office under local anesthesia. Either way, this is typically an outpatient procedure, meaning no hospital stay is needed.

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© 2017 by Jonathan C. Mills, MD