Functional Endoscopic Sinus Surgery (FESS)

What happens during surgical sinusitis treatment?

Diagnosis

Sinusitis is usually very apparent and easily diagnosed because of its distinctive symptoms such as postnasal drip, facial heaviness, pain and swelling around the eyes, cheeks, nose, or forehead, blocked nose, etc. However, a comprehensive diagnosis is necessary to determine a treatment plan, especially if the patient is not showing significant improvement through medical management. 

Common diagnostic tests performed for sinusitis are:

• Nasal endoscopy
• Lab analysis of nasal and sinus discharge
• Imaging tests like CT scan, X-ray, etc.

These tests help determine the cause of sinus infection and whether the patient has a deviated nasal septum or nasal polyps that may be contributing to their condition.

Procedure

Before the surgery, you should discuss your condition with your ENT surgeon and determine whether you need another procedure such as septoplasty, turbinate reduction, etc. in addition to FESS for effective long-term relief.

The procedure usually lasts for about 2 hours and most patients are discharged on the same day as the surgery. It is usually performed under local anesthesia to reduce the chances of anesthesia-related complications in the patient.

Once the patient has been anesthetized, the surgeon inserts a nasal endoscope through the nose. The endoscope has a light, camera and surgical instruments attached to it that help the surgeon visualize the surgical field clearly and perform the surgery. When all the diseased and infected bone, cartilage tissue, polyps, etc., blocking the sinuses have been removed, the incision is closed using stitches and nasal packing.

What to expect after a FESS operation?

After the surgery, the patient is moved to a recovery room for observation, in severe cases, you may be kept for overnight observation, but most patients are discharged on the same day. You may have a little pain and discomfort, along with some nasal congestion and discharge for 2-3 weeks. During this period you should follow your surgeon’s instructions and take your prescription medicines without fail to ensure your recovery goes smoothly.

You will be able to resume your work, school, etc. within a week and most patient can even resume their normal routine within 3 weeks. For people with strenuous and physical jobs, this period may extend for 1-2 months. You should visit your ENT surgeon for postoperative consultations for at least 3-4 months to ensure there are no complications during recovery.

When is a FESS procedure required?

You may need FESS surgery if you have chronic or recurring severe sinus infection or inflammation that is not showing significant improvement even with maximum medical management, i.e., medical treatments such as antibiotics, steroids, antihistamines, home remedies, etc.

Another significant sign you need sinus surgery is if you have nasal/sinus polyps or if your sinus infection has spread to the surrounding structures like facial bones, eyes, tonsils, brain, etc. In these instances, immediate sinus surgery is required to mitigate the damage and prevent irreversible damage to the patient.

Benefits of Functional Endoscopic Sinus Surgery procedure

One of the biggest advantages of Functional Endoscopic Surgery is that it is a minimally invasive surgery that provides long-term relief from sinusitis without any facial/aesthetic damage to the patient. Since it is a conservative surgery, very little tissue is removed and the patient has minimal postoperative pain with very low chances of complications.

Compared to other sinus surgeries like balloon sinuplasty, it has a higher success rate in the long term on the first try and does not need to be repeated in most cases. The improvement in breathing and sinusitis after FESS is also quick, hence, the patient is less reliant on medicines.

Recovery after Functional Endoscopic Sinus Surgery

You can follow the given tips to enhance your recovery after FESS:

• Elevate your head using extra pillows to reduce postoperative bleeding and swelling, especially during the first 24 hours after the surgery.
• Make sure that your nasal splint/packing material is not dislodged. Breathe through your mouth if your nose feels too blocked, but you cannot remove the splint/tissue packing.
• Contact your ENT surgeon immediately in case there is too much bleeding or drainage from the surgical site.
• Do not cough, sneeze or blow your nose for at least a week after the surgery. If sneezing is unavoidable, try to sneeze through your mouth.
• Do not perform any heavy lifting or strenuous exercise for 2-3 weeks or without approval from your ENT surgeon.
• Take medicines as prescribed by your doctor, especially anti-inflammatories and antibiotics to avoid infection and swelling of the surgical area.
• Visit your doctor for a follow-up consultation regularly to make sure that you are healing without any complications.

What is cost of Functional Endoscopic Sinus Surgery (FESS) in India?

The cost of FESS surgery for sinusitis relief ranges from Rs. 45,000 to Rs. 70,000. The surgery is minimally invasive and does not affect the facial aesthetics at all.

Some common factors that can affect the cost of the surgery are:

• Choice of treatment city
• Choice of hospital
• Total hospitalization cost
• Severity of the condition
• Diagnosis and evaluation cost
• Additional treatments required
• Post surgery care needed
• Patient’s age and overall health condition
• Surgeon’s fees
• Insurance coverage

Consult with the best ENT surgeons at Pristyn Care and get the cost estimate of FESS surgery.

Case study

Anita (pseudonym) is a woman in her late 20s who had been suffering from chronic sinusitis and related symptoms for almost 20 years. She had frequent bouts of common colds and sinus problems, along with sinus-related headaches. She had tried conservative treatments such as medicines, saltwater gargles, steam, etc., her whole life, but none of these had provided her adequate long-lasting relief. 

Finally, she approached Pristyn Care for treatment. Our ENT doctor performed a thorough physical examination, along with diagnostic tests such as tissue culture, blood tests, and CT scans. On diagnosis, it was revealed that she has been suffering from allergy-induced chronic sinusitis all this time. Additionally, the CT scans and X-ray images revealed that she has a deviated nasal septum which makes her more susceptible to sinus infections.

To ensure complete and long-lasting recovery, the ENT surgeon recommended a combined surgery, including septoplasty and FESS surgery. Her surgery was scheduled and performed within the following week. She experienced mild pain and discomfort for about 1 week after the surgery. But after one week, her airway cleared and she was able to breathe without issues for the first time in almost 20 years.