What is FESS?

Functional endoscopic sinus surgery or FESS is a surgical procedure to treat sinusitis. Sinusitis is the swelling or inflammation of tissues lining the sinuses. FESS is a minimally invasive procedure to treat the nasal congestion that results in chronic sinus infections. The surgeon uses an endoscope and other medical equipment to detect and remove any obstruction such as nasal polyps, affected tissues, mucus, etc., to restore sinus ventilation and improve breathing. As opposed to conventional methods that involve large incisions and higher risks, FESS ensures safe and effective treatment and a faster recovery. Some of the benefits of FESS surgery are -
  • Tiny incisions
  • Almost no pain
  • Minimal scarring
  • Minimal blood loss
  • Long-term health benefits
  • Chances of complications are almost nil

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  • MRI
  • X-rays
  • CT scans
  • Nasal endoscopy
  • Physical examination
  • Tests for existing allergies
  • Examining nasal and sinus discharge samples
The patient is given instructions prior to the surgery to reduce the complications during the surgery. The anesthesiologist administers local or general anesthesia to the patient before the surgery. Local anesthesia sedates the surgical site, whereas general anesthesia makes the patient unconscious. This ensures a painless experience. The surgeon begins the surgery by making a tiny incision inside the nose to insert a medical device called an endoscope. An endoscope is attached to a light and a camera on the other end to guide the surgeon inside the sinus cavity and visualize the condition of sinuses. The surgeon examines the cause of inflammation or swelling by analyzing the condition of sinuses through the images generated from the endoscopic camera on a monitor. Finally, the surgeon drains the natural passage of the sinuses and removes nasal polyps or inflammatory tissues that may be the primary cause of congestion. The whole procedure usually takes 2 to 2.5 hours, depending on the severity of the condition and the surgical experience of the ENT specialist.
  • Nose Bleed
  • Cerebral spinal fluid (CSF) leakage
  • Abnormal swelling
  • Excessive bleeding
  • Refrain from blowing the nose for at least a week after the surgery. If you have to sneeze or cough, try doing it with your mouth open to minimize nasal pressure.
  • Avoid excessive physical activity or strenuous exercises that can increase nasal pressure, which may result in nosebleeds.
  • Apply an ice pack and take adequate rest in case of excessive bleeding.
  • Elevate your head to reduce the swelling and minimize bleeding after the surgery.
  • Take your medications regularly as prescribed by the ENT doctor.
  • Regularly visit the doctor for your post-surgery recovery and check for any signs of complications.
  • Consult your ENT doctor before resuming work or school to avoid risks and complications.
  • Avoid using makeup or exposure to smoke and dust to avoid irritation or allergy around the eyes and nose.

Frequently Asked Question

No, FESS is not a painful surgery since the patient is given local or general anesthesia. This means the patient is either unconscious or in a semi-sedated state during the entire procedure for a painless experience. However, there may be mild discomfort around the surgical site after the effect of anesthesia wears off.

FESS surgery can take anywhere between 2 to 2.5 hours, depending on the health condition of the patient and the surgical experience of the ENT surgeon. If the doctor suspects the cause of nasal congestion and chooses to perform a corresponding septoplasty, the duration of the surgery will vary.
FESS is a minimally invasive surgery which means it involves tiny incisions inside the nose. There are no scars or incisions outside the nose.
Septoplasty is done if the cause of sinus blockage is the deviation in the nasal septum. FESS resolves nasal congestion by eliminating polyps sinusitis and draining the sinus passage. If the ENT doctor suspects obstruction due to both reasons, then both the surgeries are done simultaneously.
Patients can resume their daily lifestyle after 5-7 days of surgery. However, it may take around 2-4 weeks to recover completely after FESS. The recovery after FESS depends on the individual’s medical condition and how strictly they follow post-operative tips. Consult your ENT specialist before returning to school or your work.
Consider the following factors while choosing the best hospital for FESS -
  • Patient reviews
  • Facility and infrastructure
  • The reputation of the healthcare institute
  • Accessibility of the hospital (should be nearby)
  • Following proper COVID protocols
  • Availability of the ENT surgeon on the day of surgery
  • Experience of the ENT specialist
  • Number of surgeries done in the hospital by the ENT specialist
  • Track record of the hospital in conducting successful surgeries
The cost of FESS usually starts from Rs. 50,000 and can go up to Rs. 70,000. However, the overall cost of the surgery can vary depending on several factors such as location, selection of hospital, consultation fee of the urologist, medication cost, insurance coverage, etc.
Consider the following factors while choosing the best hospital for FESS -
  • Patient reviews
  • Facility and infrastructure
  • The reputation of the healthcare institute
  • Accessibility of the hospital (should be nearby)
  • Following proper COVID protocols
  • Availability of the ENT surgeon on the day of surgery
  • Experience of the ENT specialist
  • Number of surgeries done in the hospital by the ENT specialist
  • Track record of the hospital in conducting successful surgeries
Yes, some health insurance companies do cover the cost of FESS if Chronic sinusitis can cause severe breathing problems, and so, surgical procedures usually become a medical necessity. However, the insurance claim depends on the type of insurance provider and the terms and conditions set by them.

How to prepare for FESS surgery?

Your ENT doctor or the healthcare facility usually provides a set of instructions to help you prepare for the surgery and avoid complications during the procedure. Here are some instructions that can help you prepare for FESS surgery. 

  • Do not eat or drink 8 to 9 hours prior to the surgery. This means you may have to skip your dinner or refrain from eating anything after midnight before the day of surgery.
  • Inform your doctor of any ongoing medications or health conditions before the surgery. You may consult the ENT doctor before taking any medications for diabetes, sugar, etc., prior to the surgery.
  • Wear loose clothes to avoid injury to the surgical site. It is important to refrain from wearing make-up or other ornaments before the procedure. 
  • Consult the ENT doctor if you have to take any medications before the surgery with minimal water. An empty stomach will enable the anesthesiologists to put you to sleep safely. 

What to expect after FESS?

  • Expect to spend a few hours in the recovery room after the surgery. The ENT doctor will monitor your recovery and prescribe your medications. However, most patients may feel healthy enough to go home a few hours after surgery.
  • You may experience minimal bleeding, which is normal after the FESS surgery. Mild bleeding may subside after the first day. 
  • The patient may feel slight pain, including some nasal pressure, for the first several days. You can ask your ENT doctor for any medications to reduce the pain and discomfort after the surgery. 
  • The patients often feel very fatigued for the first week after the surgery. This is quite normal, and they are often advised to take a week off of their work or school before the surgery.  

Questions to ask your ENT doctor?

  • Will the shape of my nose change after the surgery?
  • Do I require septoplasty and FESS together?
  • Is my sinusitis condition acute or chronic?
  • Are there any alternative treatments for FESS?
  • Will I need another surgery after FESS?
  • What are the post-recovery dietary restrictions after FESS?
  • I have other health conditions. How can I effectively manage them together?

How can you prevent chronic sinus infections?

  • Avoid respiratory infections – Patients must avoid contact with individuals who are already suffering from cold or respiratory infections. It is also crucial to inculcate the habit of frequently washing your hand with soap and water before meals. 
  • Watch out for your allergies – Patients must avoid certain elements that can often lead to seasonal allergies, sinuses, and other respiratory infections. Consult with your ENT doctor for several remedies to minimize the symptoms of respiratory infections. 
  • Avoid exposure to polluted air – Frequent exposure to contaminated air or cigarette smoke that can irritate and inflame the lungs and nasal passages. Therefore, preventing exposure to polluted air, dust, etc., can prevent several respiratory disorders.
  • Using humidifier – Humidifiers keep your surrounding air purified and free of any impurities. A good quality humidifier ensures breathable quality air to prevent certain elements that can cause nasal congestion. However, make sure your air purifier is free of mold and cleaned thoroughly regularly.

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