What is Functional Endoscopic Sinus Surgery?
Functional endoscopic sinus surgery is a minimally aggressive surgery used to enhance the nasal pathway to improve regular function and sinus ventilation. FESS surgery is generally done to improve medical conditions like nasal polyps, rhinosinusitis, decompression of optic nerves and other chronic diseases. For diagnosis, fiberoptic telescopes are used and CT scan is done to examine the affected areas. This surgery is normally successful and used as a last resort of treating the diseases which result in breathing problems and sinusitis.
Diseases that can be treated by the functional endoscopic sinus surgery are:
- Rhinosinusitis- it is also known as sinus infection or sinusitis. Rhinosinusitis occurs when excessive mucus leads to blocked nasal passage and inflammation in the nasal cavity. Bacteria is the major cause of rhinosinusitis. Fungus, asthma and allergies can also result in this condition. Symptoms of rhinosinusitis include sneezing, headache, nasal obstruction, thick discharge from the nose, swelling, pain in the face, fever, cough, bad breath and a reduced sense of smell and taste. It usually lasts from 7-10 days but it becomes chronic sinusitis if it lasts more than 11-12 weeks.
Prevention of rhinosinusitis- avoiding second-hand smoke and smoking, preventing interactions with people suffering from sinusitis, avoiding dust, vaccination and good hygiene.
- Nasal polyps- it is defined as a painless benign growth in the inner lining of the nasal passage – also known as the nasal polyposis. It is often caused by hay fever, frequent sinus infections, asthma, allergies and sensitivity to cold. Symptoms of nasal polyps are runny and blocked nose, reduced sense of smell, snoring, sensitivity to cold, frequent cold, sore throat, stuffiness, pressure in the forehead and frequent headaches. It can be diagnosed through CT scan, MRI scan and other physical tests.
It can be removed through primary medications. If it is severe then surgery is often required to remove polyps from the passage. The recovery after nasal polyp surgery is generally for 3-4 months.
How to prevent nasal polyps- avoid pollutants which cause airborne diseases, proper treatment of asthma, sensitivity to cold and certain medications, allergies and unhygienic lifestyle.
Functional endoscopic sinus surgery effectiveness
It is more suitable for children of age 6 years or more and not preferred for children below 3 years, as they may develop the symptoms of nasal polyps or rhinosinusitis. It is effective in cases of severe nasal polyps, frequent occurrences of acute sinusitis, chronic sinusitis, deviation of septum, and enhancement of nasal turbinates. The surgery can only be done after other tests – CT scan, x-ray, and blood test. Though before surgery, home remedies are applied for at least 3-4 weeks to check the severity of the problem.
Functional endoscopic sinus surgery steps
Functional endoscopic sinus surgery includes basic test and CT scan to detect the abnormalities, then administration of anaesthesia, endoscopy, removal of defective tissue and recovery.
Functional endoscopic sinus surgery procedure
Functional endoscopic sinus surgery procedure includes anaesthesia to prevent pain or discomfort. Then endoscopy is done using a thin small pipe attached with a small camera at the top. An endoscope is inserted into the nasal passage to show images of the affected area or abnormal tissues. These abnormal tissues are either removed or repositioned for the clear pathway. In some cases, the specialist may insert a propel implant into the area. This propel is responsible for the expansion of the area and administers cortisone to prevent the reformation of polyps and reduces the formation of scars. The Propel gets dissolved over a while.
After the surgery, the patient may experience swelling and pain. Usually, nasal packing is avoided during surgery to prevent pain or discomfort, but in cases of excessive bleeding nasal packing is used. This packing can be removed after 3-4 days. Nasal packing can be removed at home or hospital with a little help.
Nasal packing is the process of placing an intranasal instrument to provide steady pressure on the nasal septum. This packing is placed to check the flow of bleeding by reducing the irritation of mucous membrane, and clots the blood which helps in increasing the pressure around the area.
After surgery, the patient has to stay for 2-3 hours in the hospital for recovery. Overnight stay can be recommended by the doctor depending on the medical condition. Functional endoscopic sinus surgery recovery is faster and the patient can start his daily routine work early.
Post-Functional endoscopic sinus surgery guidelines
Post-surgery, regular visits to the clinic are necessary to check medical stability as the symptoms may need medical attention. Some medications are provided after surgery to lessen the pain and swelling. Blowing of the nose within a week of surgery is prohibited. Recovery can take several days depending on lifestyle.
In initial days, the area is sensitive requiring special attention, rest at home is preferred. Swimming is prohibited for at least 2 weeks. No exercise should be done for 2 weeks including bending, straining, lifting as it may result in nose bleeding. Regular washes with saline water are suggested to reduce pain and swelling in the area.
Avoid coffee, tea and other drinks that cause dehydration in the body. The patient can continue his regular diet after surgery but the movement of the bowel is not as regular as that of before surgery. Consumption of yogurt, broiled chicken, plain rice and toast is beneficial in case of loss of appetite.
Functional endoscopic sinus surgery benefits
The various benefits of functional endoscopic sinus surgery are; it reduces the chances of additional surgeries; thus, surgery is successful almost 90%, fewer tissues are removed during the process. It is a minimally aggressive surgery, negligible bleeding post-surgery, least pain due to local anaesthesia, long-lasting results. No scars on the nose as it is operated from inside and cortisone is given to prevent the occurrence of the scar.
Some rare FESS complications include leakage of fluids from the nose, bleeding due to strain, problems of sight which requires additional treatment, and recurrence of the nasal disease.
FESS surgery side effects or risks
Sometimes another surgery, called septoplasty is required in addition to the functional endoscopic sinus surgery. This is done to correct the septum of the nose – Septoplasty is a small procedure. It is effective in reducing pain and swelling inside the nostril. It also includes the risk of bleeding, recurrence of deviation and numbness.
What is the cost of functional endoscopic sinus surgery?
The cost of FESS differs through locations, it can range high in developed countries. The average cost ranges from $3500-$4000. Other hospital formalities should be considered as well.
How long does the procedure of fess surgery take?
This procedure Usually takes around 2-4 hours to be completed depending on the complexity. You may or may not require to stay in the hospital a day before the surgery. After surgery, you have to stay for a few more hours to recover.
Which condition is cured by functional endoscopic sinus surgery?
Functional endoscopic sinus surgery cures nasal diseases caused due to nasal cancer or polyps. This surgery improves breathing functions by surgically removing the defective tissue in the nostril.
Is there any replacement for functional endoscopic sinus surgery?
Initially, light medications are prescribed. After no response, functional endoscopic sinus surgery is done. FESS can be replaced with sinus ostial dilation surgery, terminate reduction surgery and balloon sinuplasty.
How should a patient prepare for the fess surgery?
Avoid consumption of medications at least 7 days prior to the surgery, eat healthy food, and avoid smoking to reduce complications.