Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure used for the treatment of chronic or recurrent sinus issues. It involves the use of an endoscope, a thin tube with a light and camera, to visualize the inside of the sinuses through the nostrils. This method allows surgeons to remove obstructions like swollen or infected tissue, polyps, or bone that block sinus drainage pathways without making external incisions.
Indications for FESS include:
Chronic Rhinosinusitis (CRS): Particularly when it persists despite medical treatment. FESS aims to restore normal sinus ventilation and mucociliary clearance. This can be with or without nasal polyps, where symptoms like congestion, headaches, and difficulty breathing through the nose are significant.
Recurrent Acute Sinusitis: When individuals experience four or more documented episodes of acute rhinosinusitis in one year, surgery might be considered to prevent further recurrences.
Nasal Polyps: When polyps cause significant obstruction, leading to recurrent infections or breathing difficulties, FESS can be used to remove these growths.
Sinus Tumors or Suspected Tumors: If imaging or endoscopy suggests the presence of a tumor, FESS might be employed for both diagnostic and therapeutic purposes.
Complications from Sinusitis: Including but not limited to suppurative complications like orbital cellulitis, subperiosteal abscess, or intracranial complications.
Anatomical Abnormalities: Such as a deviated septum or other structural issues that obstruct sinus drainage. Surgery can correct these abnormalities to improve airflow and drainage.
Mucocele: A condition where a sinus becomes blocked and fills with mucus, expanding over time and potentially causing pressure on nearby structures like the eye or brain.
Allergic Fungal Sinusitis: In cases where medical management fails, FESS can be used to remove fungal debris and polyps.
Cystic Fibrosis or Asthma Aggravation: When sinus disease exacerbates these conditions, surgery might be indicated to improve respiratory function.
FESS is generally considered when medical treatments like antibiotics, nasal steroids, and saline irrigation have failed to control symptoms or when there are specific anatomical issues that predispose to chronic or severe sinus disease. The procedure aims to not only relieve symptoms but also to maintain or restore the normal function of the sinuses.