Functional Endoscopic Sinus Surgery (FESS)

Functional Endoscopic Sinus Surgery (FESS) is a modern surgical approach for treating diseases of the nose and sinuses.

What are the indications for Functional Endoscopic Sinus Surgery (FESS)?

There are three main indications for FESS:

  1. Chronic sinusitis (sinusitis, ethmoiditis, frontal sinusitis, sphenoiditis) that do not respond adequately to conservative treatment
  2. Presence of nasal polyps within the nasal cavities in the nasal chambers and paranasal sinuses
  3. Presence of tumors (benign or malignant) within the nasal chambers and paranasal sinuses

What are the paranasal sinuses?

The paranasal sinuses are air-filled cavities around and behind the nose. They communicate with the nasal chambers through natural openings to facilitate air circulation and mucus drainage.

What are the paranasal sinuses and where are they located?

The paranasal sinuses are divided into 4 groups:

  1. Maxillary sinuses (sinuses): They are the largest of the paranasal sinuses. They are located on the right and left of the nose.
  2. Ethmoid sinuses: They are small air-filled cavities and are divided into anterior and posterior.
  3. Frontal sinuses: They are located within the frontal bone. They are pyramid-shaped.
  4. Sphenoid sinuses: They are located towards the base of the skull at the back of the nose.

What is sinusitis?

The term rhinosinusitis refers to inflammation of the paranasal sinuses. The inflammation most often affects the sinuses and ethmoid air cells, while the frontal and sphenoid sinuses are less commonly affected. When the inflammation affects all the paranasal sinuses, it is called pansinusitis.

How long does sinusitis last?

Sinusitis, depending on the length of time its symptoms last, is divided into:

Acute: lasts up to 3 weeks.
Subacute: symptoms last more than 3 weeks and up to 3 months.
Chronic: symptoms of inflammation last more than 3 months.

What are nasal polyps?

Nasal polyps are inflammatory, soft formations that appear in the nasal chambers and paranasal sinuses. While they are benign formations, they tend to constantly increase in size and occupy the nasal cavity and/or the paranasal sinuses.

What are the symptoms of patients with nasal polyps?

  • Difficulty in nasal breathing: there is difficulty both in inhaling and exhaling air
  • Disorders of smell and taste
  • Postnasal discharge
  • Feeling of pressure of the face (facial pain)
  • Sleep disorders, snoring and episodes of sleep apnea (exhaustion, strain on the cardiorespiratory system)

What are tumors in the nasal cavities?

They are abnormal formations that can be located in the nose or in the paranasal sinuses. They can be benign or malignant. The most common causes of tumors can be smoking, alcohol consumption, human papillomavirus (HPV), long-term inhalation of toxic substances and polluted air.

What symptoms do nasal tumors cause?

  • Nasal obstruction
  • Epistaxis and nosebleeds
  • Pain in the face (facial pain)
  • Disorders of smell and taste
  • Pain and pressure in the teeth (toothache)
  • Deformity of the eye socket and impaired vision

How are the above diseases of the nose and paranasal sinuses diagnosed?

  • Nasal endoscopy: It is performed in the doctor's office with a flexible or rigid endoscope.
  • CT or MRI scan: the pathology of the area is identified with great diagnostic accuracy.

How is endoscopic sinus surgery (FESS) performed?

When conservative treatment does not improve symptoms or when there is a tumor. Endoscopic surgery is the treatment of choice. It is a modern method of treating diseases of the nose and sinuses, which respects the normal anatomy and function of the area. The operation is performed entirely intranasally, thus avoiding incisions and sutures on the face.

This operation can be combined with straightening of the deviated nasal septum (septoplasty) and/or cauterization of the nasal turbinates if required.

How is endoscopic sinus surgery (FESS) performed?

The operation is performed under general anesthesia. An attempt is made to clean, depending on the location of the disease, the various natural openings of the paranasal sinuses to the nose, removing the pathological tissue that prevents the natural flow of air and the removal of mucus.
The operation is performed intranasally, without external incisions.
The patient leaves the Clinic on the same or the next day of the surgery.