Functional Endoscopic Sinus Surgery (FESS) is the preferred choice for sinus surgery. This procedure results in clearance of the obstruction between the sinuses and the nasal passageway by restoring the normal flow of mucus out of the sinuses. The goal of FESS is to improve sinus drainage with minimal removal of sinus tissue.
The sinus openings are surgically opened or enlarged and areas of tissue and bone inflammation are removed. FESS involves the use of a fiberoptic endoscope through which the doctor can view the nasal airway and sinus openings. In an operating room setting, surgical instruments can be manipulated along with the endoscope for direct observation. The surgery is usually done under general anesthesia.
Surgeons may also by assisted by interventional video tomography (IVT). This digital x-ray-like imaging technique provides an accurate roadmap for surgery. X-ray landmarks of your sinuses are seen in real time on a monitor. This allows the surgeon to know his/her exact position at all times. Use of IVT is reserved for complex cases or repeat procedures where normal anatomic landmarks no longer exist.
FESS is relatively safe and minimally invasive. There are no skin surface incisions and very little post operative pain. Recovery is much faster than traditional sinus surgery. However complications can occur (approximately 0.5% rate). Complications include serious bleeding, permanent eye damage and leakage of cerebral spinal fluid. Other complications can include nasal septal performation, decrease or loss of sense of smell and post surgical scar tissue. In a small number of cases, repeat procedures may be required if the initial procedure does not result in significant improvement of symptoms. Individuals who smoke after sinus surgery have a significantly poorer long term prognosis than nonsmokers.