FESS expectations and complications

The sinuses are bone made air-filled cavities inside our face and the skull. Sinus infection also referred to as rhinosinusitis, is an inflammation or of the soft tissues that line the sinuses. This inflammation or swelling can stop your sinuses from draining properly. The buildup can then lead to infection, which causes even more inflammation and pain. We have four types of sinuses:

  • Frontal sinuses
  • Ethmoid sinuses
  • Sphenoid sinuses
  • Maxillary sinuses

Millions of people have afflicted with sinus disease on a yearly basis. Most cases respond to medical therapy, but if no improvement in symptoms is visible, patients are referred to an ENT specialist for further medical and surgical intervention. Functional endoscopic sinus surgery (FESS) supports a systematic approach to the surgical treatment of diseases of the nose and paranasal sinuses.

an image showing para-nasal sinus

Take the sinus pressure away!

By implementing a systematic approach to nasal endoscopic examination, physicians can give special attention to the anatomic and pathologic detail of the anterior ethmoid, middle meatus, and middle turbinate region. The surgical correction of these structures restores the normal anatomic boundaries and reestablishes normal patterns of sinus drainage. Investigators have reported success rates of 86% or more with this approach in patients carefully screened and selected for surgical management.

This success rate will increase as newer instrumentation continues to be developed and improves the surgeons’ ability to safely and accurately treat sinus disease. Major complications, although rare, can occur during sinus surgery and include hemorrhage, intracranial injury, and visual disturbances.

Also Read: Is it possible to straighten the deviated nose?

How do we get sinus infections?

Everyone understands the horrors sinusitis inflicts which include runny nose, headache, sinus congestion. Is it just a cold? Or something more serious? If it’s a sinus infection, that’s a much more serious condition. About 136 million Indians suffer from chronic sinus infections as per news shared by one of the biggest news channels in India. If you’re one of the sinus patients and continue to battle sinus pain, and emotional drain for over 8 – 10 weeks or more, no matter what treatments you try, you may be dealing with chronic rhinosinusitis.

Identification of sinusitis

Sinus inflicts problems such as congestion, discharge, and pressure with facial pain or headaches, also, if the discharge from the nose is yellow or discolored, you may have a sinus infection.

Chronic sinus infections that persist for a long period of time can reduce your quality of life and make you constantly tired. If you have asthma, you need to keep a close watch on sinus infections as it may make it worse if inflamed.

a doctor diagnosing the sinus patient


The major symptoms for sinusitis are listed below:

  • Headaches
  • Facial pain or pressure
  • Difficulty breathing through the nose
  • Nasal discharge that isn’t clear
  • Fever
  • Fatigue
  • Upper tooth pain
  • Bad breath

A patient may experience emotional duress:

  • Limiting physical activities
  • Taking sick days from work
  • Being too ill to socialize
  • Nasal discharge that isn’t clear
  • Having problems sleeping
  • Feeling moody and miserable
  • Avoiding social situations


Doctors classify the causes of sinusitis this way:

  • Anatomical causes: deviated septum or enlarged turbinates
  • Inflammatory and infectious causes: bacterial, viral, fungal infections, allergies, and polyps
  • Developmental disorders: cystic fibrosis
  • Tumors in the nose and sinuses: may result in blockage of critical drainage pathways

The underlying cause behind your sinusitis may have implications for how you respond to treatment and which treatment options your doctor recommends.


A CT scan of your sinuses will confirm your diagnosis and help your doctor determine whether surgery is right for you. To diagnose a sinus infection, your doctor will ask about your symptoms and medical history. A good ENT specialist may tap areas of the face to assess if any sinus openings are tender. An ENT specialist may also take a sample of your nasal discharge to determine what kind of infection you might have.

Your doctor may order a CT scan that creates images of the inside of your sinuses. This can help your doctor more accurately diagnose your condition and select the best treatment option for you. Some sinus may be treatable with medical therapy and/or lifestyle changes, while others may require surgery. Most short-term sinus infections can be treated medically. Even patients of long-term or chronic sinus infections may find relief through medication with extreme care. But if none of these treatments works for you, sinus surgery may be the best way to ease your symptoms.

Medical treatments are typically tried first. An ENT specialist doctor will recommend surgery only after all other treatments have failed to deliver desired results.

Also Read: Is it possible to straighten the deviated nose?

Functional Endoscopic Sinus Surgery (FESS)

an image showing FESS process

Functional endoscopic sinus surgery is a common surgical method to treat chronic sinus infections. The procedure follows as the surgeon uses a magnifying endoscope and insert the same through the nostrils for better imaging of affected tissue and bone.


  • Ethmoidectomy: helps clear sinuses located between your eyes and the bridge of your nose
  • Maxillary antrostomy: helps the sinuses behind your cheekbones drain more effectively
  • Powered septoplasty with Turbinoplasty: helps clear up breathing difficulties caused by a deviated or crooked nasal septum and enlarged turbines in your nose


Despite the availability of newer instrumentation, complications may still occur. Anatomic boundaries are the same in all patients and the surgical operator not familiar with the proper implementation of this kind of instrumentation in the context of the challenging surgical anatomy of the nose can easily become disconcerted. We strongly advocate the continual clinical correlation of the surgical anatomy with the patient’s CT scan during the procedure. We also strongly recommend, especially for the inexperienced operator, frequent cadaveric practice with nasal endoscopes.

After healing your sinus with FESS

Once your nose and sinuses are healed, you should be able to resume your day-to-day activities. The results of surgery are never guaranteed, however. It’s possible that your symptoms may improve after sinus surgery, or you may still need some kind of medical therapy to manage your symptoms after surgery. Your doctor can provide more information. Make an appointment with the best doctor for you if you have other doubts or want to learn more about the FESS or complications.

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