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Functional Endoscopic Sinus Surgery

(FESS)

How to Say It: Funk-shun-nul End-o-skop-ik Si-nus Sir-jury

Definition

Functional endoscopic sinus surgery enlarges pathways to the sinuses. It is done using a special tube that can be passed through the nose.

Reasons for Procedure

The sinuses are hollow areas in the skull that are arranged in pairs. Mucus and other fluids drain from the sinuses through small pathways to the throat. Blockage of these pathways can cause fluids to build up in the sinuses. This can cause pain and infection.

This surgery is done to open the pathways for drainage. It may be done for people who have recurring sinus infections that have not responded to other treatments.

Sinus Infection

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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Damage to the optic nerve
  • Spinal fluid leakage
  • Narrowing of the tear duct

Smoking may raise the risk of problems.

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging for a ride to and from surgery

Anesthesia

The doctor may give:

Description of the Procedure

A thin tube called an endoscope will be inserted into the nose. The scope allows the doctor to view the inside of the nose. Other tools are passed through the nose to remove abnormal tissues and open the sinus pathways. The nose may be packed with bandages and splints.

How Long Will It Take?

2 to 4 hours

Will It Hurt?

You may have discomfort and feel tired in the first week. Medicine and home care can help.

Will It Hurt?

You will have mild swelling and discomfort. Ask your doctor about pain medication.

Average Hospital Stay

Most people can go home the same day. If you have problems, you may need to stay longer.

Post-procedure Care

At the Care Center

Right after the procedure, the staff may give you pain medicine.

At Home

It will take 2 to 3 weeks for breathing to return to normal. Some physical activities may be limited. You may need to delay your return to work.

Call Your Doctor

Call your doctor if any of these occurs:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge from the nose
  • Pain that you cannot control with the medicine
  • Nausea and vomiting
  • Lightheadedness
  • A headache that lasts longer than two days after surgery
  • Bruising around the eye(s)
  • Swelling of the eye(s)
  • Changes in vision

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

CANADIAN RESOURCES:

Canadian Society of Otolaryngology—Head and Neck Surgery
http://www.entcanada.org

The College of Family Physicians of Canada
http://www.cfpc.ca

REFERENCES:

Chronic rhinosinusitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-rhinosinusitis. Accessed August 4, 2021.

Functional endoscopic sinus surgery. UNC School of Medicine website. Available at: https://www.med.unc.edu/ent/patient-care/clinical-services/sinus-and-allergy-1__trashed/functional-endoscopic-sinus-surgery. Accessed August 4, 2021.

Functional endoscopic sinus surgery (FESS). The Children’s Hospital of Philadelphia website. Available at: https://www.chop.edu/treatments/functional-endoscopic-sinus-surgery-fess. Accessed August 4, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board James Cornell, MD  Last Updated: 8/4/2021