Endoscopic Sinus Surgery

It is minimally invasive procedure done endoscopically and does not require any external skin incision. This is newer technique of minimally invasive surgery possible due to development of-
 Better optics and scope
Microsurgical instruments and illumination
Radiography-CT SCAN / MRI
Introduction of microdebrider

Sinuses are air-filled spaces in the bones of the face and head. They are connected to the inside of the nose through small openings. The sinuses are important in the way we breathe through the nose and in the flow of mucus in the nose and throat.

When the sinuses are working properly we are not aware of them but they often are involved in infections and inflammations which cause symptoms. These infections and inflammations are called sinusitis. Sinusitis is caused by blocked, inflamed or infected sinuses. Patients will often complain of a blocked nose, pressure or congestion in the face, runny nose or mucus problems. Other symptoms include headache and lose of sense of smell.

 Chronic sinusitis is one of the most common indication for FESS. Others include 
  • Nasal polyposis
  • Mucocoele of frontal or maxillary sinus
  • Fungal sinusitis with fungal ball
  • Foreign body in nose
  • Chronic sinusitis unresponsive to medical treatment
  • Control of epistaxis.
  • Removal of angiofibroma and inverted papilloma
  • Orbital abscess
  • Dacrocystorhinostomy
  • Repair of CSF leak and choanal atresia
  • Optic nerve decompression

It is usually perfomed under general anaesthesia but can also be done under sedation or local anaesthesia.

Immediately after the operation you may feel your nose blocked. This may be because of some dressing inside your nose or some special plastic sheets called splints. Dressings, if used, will usually be removed from your nose within 24hrs but plastic splints may have to stay longer. It is common to have a stuffy blocked up nose even after removing the dressing or splints and this does not mean that the operation has not worked.

COMPLICATIONS are rare but can be managed effectively and depends on skill of surgeon, availability of instrument and skilled staff.

  • Nasal bleeding
  • Reduced sensation of smell
  • Watering from eyes
  • Adhesion of nasal cavity
  • Dental pain
  • Orbital haemorrhage
  • Csf leak
  • Blindness or diplopia

Why is sinus surgery required?

Endoscopic sinus surgery is only one approach to the treatment of sinusitis. Endoscopic sinus surgery is as safe, and possibly safer, than other methods of operating on the sinuses.
The other methods of operating on the sinuses involve cuts in the face or mouth and if you feel that this maybe more appropriate in your case you should discuss this with your surgeon. In some patients an operation can be avoided by use of antibiotics and steroid medicines, again this should be discusssed.

What are the risks involved?

All operations carry some element of risk in the form of possible side effects. There are some risks that you must know about before giving consent to this treatment. These potential complications are very uncommon. You should discuss with your surgeon about the likelihood of problems in your case before you decide to go ahead with the operation. Nasal bleeding, orbital complication like diplopia, csf leak which can be managed effectively.

How much time will I need to recover from the procedure?

You can expect to go home on the day of your surgery or the day after your operation depending on the size of your operation. You will need to rest at home for at least a week. If you do heavy lifting and carrying at work you should be off work for at least two weeks. You will be given instructions on when to return to the hospital for your follow-up visit

Is the procedure painful?

There will be little pain after procedure which can be reduced with analgesics