Chronic rhinosinusitis affects 10% of the population in Europe.
Endoscopic sinus surgery or ESS (previously referred to as functional endoscopic sinus surgery or FESS) is the commonest operation performed for patients with chronic rhinosinusitis. Patients may present with a range of symptoms ranging from nasal obstruction, reduced sense of smell, nasal discharge and facial pain. Please see the EPOS 2020 document to read more about chronic rhinosinusitis and nasal polyps.” Insert the hyperlink for the words in bold.
Prior to consideration of any surgery, patients are treated for weeks if not months with topical medications such as nasal douches, nasal steroid sprays or drops, oral antibiotics and oral steroids.
Treatment must be tailored to the individual patient. If there is no improvement, a CT scan of the sinuses is necessary to illustrate sinonasal anatomy for surgical planning and to help determine the extent of disease.
Surgery itself is conventionally carried out under general anaesthesia, particularly for moderate to severe sinonasal disease. It typically takes 1 to 1.5 hours and involves opening up the natural drainage pathways and removing unhealthy tissue or nasal polyps. The aim of surgery is to improve the nasal airway, alleviate nasal obstruction and to permit better delivery of medication. The sense of smell can improve after surgery but is not guaranteed.
Surgery Duration
Endoscopic sinus surgery (FESS) usually takes between 1 to 3 hours, depending on the complexity and extent of the procedure. Factors like the severity of sinus disease and the number of sinuses treated can affect the duration.
Time Off Work
After FESS, most people can return to work within 1 to 2 weeks, depending on their recovery and job requirements. If your job involves strenuous activities, you may need additional time off.
Hospital Stay
FESS is typically performed as a day case procedure, so most patients go home the same day. However, in some cases with complications or underlying health issues, an overnight hospital stay may be required.
Reasonable Mobility
You can expect to have reasonable mobility within a day or two after endoscopic sinus surgery. While light walking is encouraged to promote circulation, you should avoid bending over or engaging in strenuous activities for at least a week.
Exercise
After endoscopic sinus surgery, you should avoid vigorous exercise for about 2 to 4 weeks to allow for proper healing. Light activities, such as walking, can usually be resumed within a week, but it's important to follow your surgeon's specific recommendations.
Full Recovery
Full recovery from endoscopic sinus surgery typically takes about 4 to 6 weeks, though some improvement in symptoms may be noticed sooner. Complete healing, including the resolution of any lingering swelling, can take several months.
Patients with insurance
Mr Unadkat is recognised by most of the major insurance companies. If you are insured by a company not listed below, then please do let us know in advance and we will arrange the necessary registrations.
- BUPA
- BUPA Global
- HEALIX
- Vitality
- AXA
- AXA Global
- WPA
- Cigna
- Cigna Global
- Freedom
- Allianz
- Aetna
- The Exeter
- And more.
Candidates for FESS typically include individuals suffering from chronic sinusitis, nasal polyps, or other sinus conditions that have not responded to medical treatments. A thorough evaluation by an ENT specialist is necessary to determine suitability.
FESS is usually performed under general anaesthesia or local anaesthesia with sedation, depending on the complexity of the surgery.
After FESS, you may experience nasal congestion, mild discomfort and some bleeding. It is crucial to follow your surgeon’s guidelines which may include the use of nasal washes, nasal steroids, antibiotics and attending follow up visits. You may have nasal splints inserted for up to a week following your surgery.
FESS has a high success rate in relieving symptoms of chronic sinusitis and improving quality of life for many patients. However, individual outcomes can vary, and some patients may still require additional treatments.
In patients with nasal polyps, the polyps can recur, especially in those with asthma and an intolerance to aspirin and ibuprofen (non-steroidal anti-inflammatory drugs). In such cases, more than one surgery may be necessary. Many patients will need life long nasal steroid medication. For patients undergoing revision surgery, you may require image navigation during the procedure to reduce the risks of complications.
While FESS is generally safe, potential risks include infection, bleeding, nasal obstruction, scarring or persistent symptoms. Rare but serious complications, may occur in complex cases. Discuss all potential risks and benefits with your surgeon.
