Sinus polyps can obstruct nasal passages and make breathing difficult, leading to difficulty with sense of smell or even the loss of it altogether.
Nasal surgeries usually take place as day case procedures, allowing patients to return home a few hours postoperatively. Some discomfort and sensation of pressure is to be expected following sinus surgery; to reduce discomfort you can rinse twice daily with a saline rinse kit available from pharmacies.
What Is Functional Endoscopic Sinus Surgery?
Functional endoscopic sinus surgery (FESS) is a minimally invasive surgical process that uses nasal endoscopes — thin tubes equipped with lights and lenses designed to see inside your nose and throat — to treat chronic sinus conditions. Healthcare providers commonly perform FESS to help relieve symptoms associated with chronic sinusitis as well as to remove nasal polyps. If medical treatments for your symptoms haven’t provided sufficient relief, consult with a healthcare provider about whether FESS could be the right choice.
Before having surgery, avoid smoking and aspirin use as both can increase how much you bleed during and post-surgery. Furthermore, inform your healthcare provider of any additional health conditions you have.
How Is Functional Endoscopic Sinus Surgery Performed?
Functional endoscopic sinus surgery (FESS) is an innovative minimally invasive surgery procedure for chronic sinus inflammation and disease. Healthcare providers use thin tubes with lights and lenses called nasal endoscopes during this surgery to relieve your symptoms without making incisions in or around your nose; surgeons typically perform it outpatient-style. FESS may be recommended if traditional treatments such as antibiotics and allergy medication do not provide relief.
Endoscopic sinus surgery techniques continue to evolve with imaging studies and instrumentation advancements, however there can still be potential minor and major complications to be mindful of during surgery. A stepwise approach should be used in order to recognize and respect consistent landmarks throughout the procedure to reduce any risks of complications that could arise from endoscopic sinus surgery.
Rhinologists must always bear in mind the wide variance in paranasal anatomy, making computerized tomography and radiologic studies essential to ensure successful sinus surgery procedures. By reviewing computerized tomography and radiologic studies extensively before performing sinus surgery procedures, surgeons can gain an in-depth knowledge of anatomy as well as avoid potential risks during their procedures – both minor and major ones.
Pre-operatively, surgeons must assess patients to ascertain their eligibility for endoscopic surgery using only endoscopes. This involves considering both general and local anesthesia contraindications as well as an otolaryngologist’s assessment of lesions/pathologies for suitability for endoscopic intervention.
Once a patient is determined suitable for endoscopic surgery, their surgeon should utilize an image-guided navigation system and upload and register their image-guided navigation system to enable more thorough dissection, negative margins in cases of scarring and decreased complications risk.
Once in a supine position, a surgeon will insert a nasal endoscope into each nostril and perform a sinus endoscopy. They will then infiltrate the lateral nasal wall near the uncinate with 1% lidocaine and 1:100,000 epinephrine using a 3 ml syringe and 27 gauge needle for infiltration. Subsequently, an otolaryngologist will place cotton pledgets soaked with oxymetazoline inside their middle meatus before packing the patient’s nose for drainage purposes.
Before having surgery, it is crucial for patients to refrain from smoking for several weeks prior to and refrain from drinking after midnight on the night before surgery, since both can increase bleeding during and post-procedure. Furthermore, they should prepare themselves by scheduling a complete blood count (CBC) and coagulation screen prior to having any form of surgical procedure completed on them.
What Are the Risks of Functional Endoscopic Sinus Surgery?
People suffering from sinus polyps can often benefit from surgery to address them. Surgery can relieve chronic sinusitis symptoms, reduce nasal obstruction and decrease frequency of nosebleeds while improving quality of life overall. Like any surgical procedure, functional endoscopic sinus surgery carries risks; commonly experienced complications of FESS include nasal septal deviation, ethmoiditis and postoperative bleeding.
Risks associated with surgical procedures can be reduced by making sure the surgeon is aware of them and takes necessary steps to minimize them. This involves performing an in-depth exam and verifying that each candidate meets all criteria needed for the procedure.
As surgeons are experts at performing complex procedures such as nose and sinus surgeries, it is also vital that they understand the correct ways of conducting them. Training and experience will help lower risk.
An ideal surgeon must also have an in-depth knowledge of the anatomy of sinuses and orbits. This will enable them to better comprehend how nasal cavities relate to ocular nerves and cranial structures, ensuring safe operations with minimal damage caused.
FESS can increase your risk of orbital emphysema, which occurs when surgeons make incisions into the nasolacrimal duct and cause excessive tear production and discomfort to occur. You can reduce this risk by limiting endoscope usage near inferior turbinate ostium regions.
Other complications associated with FESS may include loss of sense of smell, nosebleeds, and eye inflammation – these side effects usually resolve rapidly.
FESS can be conducted under either local or general anesthesia and typically completed as an outpatient procedure, though some doctors will ask their patients to stay overnight so that any signs of complications can be monitored more closely – this is particularly relevant if a patient has experienced previous sinus infections, other medical issues that might cause complications, or has other conditions that require care after surgery. Afterward, it’s crucial that they follow up with a board-certified ear, nose and throat physician so that any potential issues can be identified quickly and treated before going forward with FESS surgery.
What Are the Benefits of Functional Endoscopic Sinus Surgery?
FESS is designed to address sinus problems and make breathing easier. Your healthcare provider uses an endoscope (a tube with a tiny camera) inserted into your nose for this procedure in order to gain an inside view of blocked sinuses, followed by surgical tools used alongside an endoscope in order to remove polyps and blockages, enlarge narrow sinus cavities, and improve airflow through your nose.
Functional endoscopic sinus surgery offers more than simply nasal polyp removal; it can also treat other sinus conditions that cause pain and congestion, including chronic sinusitis which lasts three months or more without responding to medication, manifested in symptoms like nasal congestion, runny nose, facial pressure headaches and loss of smell. Other conditions requiring surgical treatment might include deviated septum, turbinate inflammation or diseased/abnormal tissue growths in the nose.
Based on your symptoms, your healthcare provider may suggest an invasive sinus procedure like balloon sinuplasty or traditional open-sinus surgery as the solution for your sinus issues. Although less invasive than previous techniques, such procedures do not address inflammation that contributes to sinus issues.
After your procedure, your healthcare provider may place splints or tubes in your nose to keep the sinuses closed while they heal. They might also suggest using a saline nasal rinse twice daily from a drugstore kit that includes either a squirt bottle, neti pot or other device and sterile saline solution.
Most people recover from FESS in one to two weeks. You should expect your nose to ooze blood in the initial few days and experience facial achiness or pain similar to sinus infection symptoms, and your sense of smell could temporarily diminish – this complication is rare; other potential risks could include bleeding that requires return to the operating room to stop, injury to your base of skull with leakage of spinal fluid, double vision symptoms if any develop, double vision symptoms etc. If any such complications develop immediately contact healthcare provider immediately!
