Functional Endoscopic Sinus Surgery (FESS)

Preparation Before Endoscopic Sinus Surgery

• A healthcare provider usually suggestsmedications to reduce inflammation and infection of the sinuses before the surgery. Medications to reduce respiratory secretions are usually given the night before the surgery.
• Patients who routinely take aspirin, anticoagulants, or NSAIDs should cease taking them at least two weeks before surgery since they increase the risk of bleeding.
• You must avoid smoking for at least a month prior to surgery and for at least a month afterward since it prevents quick recovery.
• The night before the procedure, you need to check into the hospital. You must avoid eating or drinking after midnight to avoid the chances of anesthesia-related complications. You can occasionally need intravenous liquid to stay hydrated.

What Happens During FESS (Functional Endoscopic Sinus Surgery)?

Step 1 · 30–60 mins

Hospital Admission

The patient arrives at the hospital on the scheduled day of surgery.

Registration and admission formalities are completed.

Vital signs such as blood pressure, pulse, temperature, and oxygen levels are checked.

CT scan reports, nasal endoscopy findings, blood tests, and other pre-operative investigations are reviewed.

Step 2 · 20–40 mins

Pre-surgery Preparation

The ENT surgeon reviews the patient's symptoms, sinus disease, and surgical plan.

The anesthetist performs a final pre-anesthesia assessment.

Consent forms are signed after discussing the procedure, expected benefits, recovery, and possible risks.

The nose is cleaned and prepared for surgery.

An IV line is started for fluids, antibiotics, and medications.

Step 3 · 10-15 mins

Anesthesia Administration

The patient is taken to the operation theatre.

General anesthesia is usually administered to ensure a pain-free procedure.

The patient remains asleep and comfortable throughout the surgery.

Step 4 · 1-2 Hours

FESS Procedure Begins

The ENT surgeon inserts a thin endoscope through the nostrils, eliminating the need for external incisions.

Specialized endoscopic instruments are used to remove blocked tissue, nasal polyps, or diseased sinus tissue while preserving healthy structures.

The natural sinus openings are widened to improve ventilation and drainage.

The sinus cavities may be irrigated with sterile saline to remove mucus, pus, and debris.

The surgeon checks for proper airflow and bleeding control before completing the procedure.

Nasal packing may be placed if required, although many patients do not need it.

Step 5 · 1-2 Hours

Recovery Room Observation

The patient is shifted to the recovery room for monitoring.

Nurses monitor blood pressure, pulse, oxygen levels, breathing, and overall comfort.

The patient is observed for nasal bleeding, pain, or other immediate complications before discharge.

Step 6 · Same Day or Within 24 Hours

Discharge & Recovery

Most patients return home on the same day or within 24 hours after FESS.

Pain relief medicines, saline nasal sprays or irrigations, and antibiotics (if prescribed) are provided.

The patient is advised to avoid forceful nose blowing, heavy lifting, strenuous exercise, smoking, and dusty environments during the initial recovery period.

Regular saline nasal irrigation and follow-up nasal endoscopy may be recommended to promote healing.

Follow-up appointments are scheduled to monitor recovery and ensure the sinuses remain clear.

Patients should seek immediate medical attention if they experience heavy nasal bleeding,

Endoscopic Sinus Surgery Recovery

You must follow all the instructions provided by your healthcare provider to promote healing after the surgery. It may include wound care, medication usage, and nasal care.

• You can expect discomfort, pain, and swelling after the surgery. But these symptoms can be managed with prescribed pain medications. Proper rest is crucial during this time to promote healing.
• You must avoid excessive exercise during the recovery period as it can delay tissue healing. 
• Nasal saline rinses or sprays can treat common nasal symptoms like congestion, discharge, or slight bleeding. 
• You must attend all the scheduled follow-up appointments with your doctor to track your recovery and resolve any issues. The recovery period after surgery can vary depending on the specific condition.
• For a successful and hassle-free recovery, it’s essential to follow all the instructions provided by your healthcare provider.

Lifestyle Changes After Endoscopic Sinus Surgery

After undergoing sinusitis surgery, a doctor usually suggests making certain lifestyle changes to promote healing and lower the chance of problems. Some common lifestyle changes are as follows:

• Adopting a healthy lifestyle can help your immune system and sinuses overall. This involves managing stress, getting regular exercise, eating a balanced diet, and getting enough rest.
• To keep the nasal passages moist, remove mucus, and avoid crusting following surgery. Examples include gentle saline rinses or prescribed nasal sprays.
• Avoiding irritants that aggravate sinus symptoms or slow down healing. You must avoid allergens, smoking, potent odors, and environmental contaminants that can irritate and inflame the nasal passages.
• A healthcare provider usually advises using a saline solution for sinus irrigation to clear mucus and promote healing. To ensure safe and efficient sinus irrigation, it’s crucial to employ the right method and sterile tools.
• It is important to adhere to the detailed post-operative instructions that your healthcare provider gives you. 
• Avoid recognized triggers and maintain an allergen-free environment.

Risk & Complications Associated with Endoscopic Sinus Surgery

Some common risks and complications associated with endoscopic sinus surgery are as follows:

• Bleeding: You can expect some bleeding for the first three to five days following sinus surgery. If you suffer continuous bleeding, gently inhale through your nose while tilting your head back slightly. You can use oxymetazoline nasal spray if the bleeding does not stop. 
• Infection: Like any surgical procedure, endoscopic sinus surgery also carries a risk of infection There is a possibility of developing an infection at the surgical site or within the sinuses after the surgery. To minimize the risk of infection, a doctor usually prescribes antibiotics. 
• Fatigue: You can feel tired for the first week after surgery. A doctor usually suggests taking proper rest for at least one week to promote recovery. 
• Changes in smell or taste: There is a risk of temporary or permanent changes in the sense of smell or taste that can occur following sinus surgery. This can be due to disruption of the olfactory nerves or swelling of the nasal tissues.
• Facial pain or pressure: You can expect facial pain or pressure immediately after surgery. This discomfort typically subsides with time, but in rare instances, it may persist.
• Eye or vision problems: In some rare instances, sinusitis surgery can potentially lead to eye-related complications such as double vision, vision loss, or injury to the eye. Prompt medical attention is required in such cases.

Endoscopic Sinus Surgery Cost

The average cost of endoscopic sinus surgery in India is Rs. .  However, this is the estimated cost of sinusitis surgery, the final cost of surgery depends on various factors. Some common factors that can affect the cost of the surgery are:

• City of the treatment
• Choice of hospital
• Total hospitalization cost
• Severity of the condition
• Diagnosis and evaluation cost
• Post-surgery care 
• Patient’s age and overall health condition
• Surgeon’s fees
• Insurance coverage

₹65500

₹85500

₹105500

Does Insurance Cover the Cost of Endoscopic Sinus Surgery?

Yes, most companies in India cover the cost of sinusitis surgery. However, the specifics can vary from policy to policy. There are a few healthcare insurance providers in India that may cover sinusitis treatment:

• Star Health Insurance
• New Health Insurance
• Bajaj Allianz
• Religare
• ICICI Lombard

Questions to Ask Your Surgeon Before FESS Surgery

Before undergoing FESS surgery, it is important to ask the following questions to your surgeon to have a better understanding of the procedure and the risks and complications associated with it:

• Is Functional Endoscopic Sinus Surgery (FESS) safe?
• What is FESS surgery success rate?
• What are the risks and complications associated with FESS surgery?
• What is the duration of FESS surgery?
• How effective is FESS sinus surgery?
• What is FESS surgery recovery time?
• What are the advantages of FESS surgery?
• What are the indications of FESS surgery?
• What precautions do I need to take after FESS surgery?
• When can I resume my daily activities after undergoing FESS?
• What are the risk factors for FESS surgery?
• What are long-term FESS surgery complications?
• What conditions are treated with FESS?
• What are the different types of FESS surgery?
• How long is FESS procedure?
• What will happen if I prolong the FESS procedure?
• When should I consult a healthcare provider after FESS surgery?

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