Nasal congestion that doesn't improve is often mistaken for a common cold or allergies. However, this condition can be a sign of chronic sinusitis , an inflammation of the sinus cavities that lasts longer than 12 weeks. If it persists for a long time and doesn't improve with medication, an ENT specialist may recommend FESS (Functional Endoscopic Sinus Surgery) .
So, what exactly is FESS? Is this surgery really performed without incisions?
What is FESS?
Functional Endoscopic Sinus Surgery (FESS) is a modern surgical procedure to treat sinus disorders using an endoscope, a small camera inserted through the nostrils. Unlike conventional surgery, this procedure does not require facial incisions , making recovery generally more comfortable.
The main goal of FESS is to open blocked sinus passages so that mucus can drain properly, while restoring normal sinus function.
When is FESS Required?
Not all sinusitis sufferers require surgery. Most patients can improve with medications, nasal sprays, or other therapies.
However, an ENT specialist may consider FESS if the patient experiences conditions such as:
- Chronic sinusitis that does not improve despite optimal treatment.
- Frequently recurring sinusitis.
- Nasal polyps which cause the nose to remain blocked.
- Sinus tract obstruction due to anatomical abnormalities.
- Sinus infections that cause complications or interfere with quality of life.
Before deciding on surgery, the doctor will usually perform a thorough examination, including a nasal endoscopy and, if necessary, a sinus CT scan.
How is the FESS Procedure Performed?
During the procedure, the doctor will insert an endoscope through the nostrils so the sinus area can be clearly seen on a monitor. Using special instruments, the doctor will remove tissue obstructing sinus drainage, such as polyps or inflamed tissue, without making any incisions in the facial skin.
Because it uses endoscopic technology, this procedure allows the doctor to work more precisely so that healthy tissue around the sinuses can be maintained.
What are the advantages of FESS?
Compared to older surgical methods, FESS has a number of advantages, including:
- Does not require facial incisions.
- Surgical wounds are more minimal.
- Pain after the procedure is generally milder.
- Less bleeding.
- Recovery time is relatively faster.
- Helps reduce sinusitis recurrence when combined with proper treatment.
However, the results of each patient may vary depending on the condition of the disease and compliance with post-operative check-ups.
What to Do After Surgery?
After undergoing FESS, patients are usually allowed to go home, depending on their individual condition. The doctor will prescribe medication, nasal saline solution, and schedule regular check-ups to clean the nasal cavity and monitor the healing process.
During the recovery period, patients are advised to:
- Avoid picking or blowing your nose too hard.
- Avoid heavy physical activity for several days as recommended by your doctor.
- Use medications and nasal sprays as prescribed.
- Come for check-ups according to the schedule that has been determined.
When Should You Consult an ENT Doctor?
Get checked immediately if you experience:
- Nasal congestion for more than 12 weeks.
- Pain or pressure in the cheeks, forehead, or around the eyes.
- Recurrent colds with thick, yellow or green mucus.
- Decreased ability to smell.
- Sinusitis that often recurs even though you have taken medication repeatedly.
Early treatment can help prevent complications and improve quality of life.
Conclusion
FESS is a modern sinus surgery procedure performed through the nostrils without facial incisions . This procedure is an effective option for patients with chronic sinusitis or nasal polyps that do not improve with treatment.
If you frequently experience persistent nasal congestion, don't dismiss it as a common cold. Consult an ENT specialist to determine the cause and receive the most appropriate treatment.
Article written by Dr. B. Vimala Acala Pramuditya, Sp.THT-KL (Ear, Nose, Throat, Head and Neck Specialist, EMC Pekayon Hospital).