Endoscopic Sinus Surgery

What is Endoscopic Sinus Surgery?

Functional Endoscopic Sinus Surgery (FESS) is the gold standard currently for the surgical treatment of sinusitis. It simply means widening the natural exits of the sinuses so that they can drain and do not become blocked.

What is Sinusitis?

We have very large sinuses with very small exits. When those exits become inflamed by infection, allergy, or other irritation, they can narrow even further to the point that they are completely blocked. Mucus is trapped and bacteria can then grow in the trapped space causing further inflammation, pressure, pain, fever, etc.

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Why is Sinusitis Treatment performed?

All treatment for sinusitis is geared toward improving the mucociliary clearance. Antibiotics treat the infection, but also reduce the inflammation they cause allowing the exits to widen and the sinuses to drain appropriately. Nasal sprays try to decrease inflammation around those same exits. Nasal saline irrigation tries to remove the irritants that cause inflammation within the nose. Surgery is just the next step.

Ideal Candidate for Endoscopic Sinus Surgery

Any patient with recurrent or chronic sinusitis is a potential candidate for sinus surgery. Surgery is rarely a necessary requirement to treat sinusitis. Usually, it is an option that is available among a spectrum of choices. For most patients, medical therapy can control or resolve their sinus problems, allergy treatment can do the same. For those who fail to respond to these more conservative options, surgery is the next possible step.

What is the Endoscopic Sinus Surgery Process?

Endoscopic sinus surgery is a minimally invasive procedure that can improve the efficiency of the natural drainage passages of the sinuses without incisions. The objective of the endoscopic technique is to minimize downtime and tissue trauma while alleviating the symptoms of chronic sinusitis. When the sinuses have narrow drainage pathways, caused by inflammation or other factors, the sinus cavities do not drain as they should. The natural nasal secretions that get trapped in the sinuses often become infected. Without intervention to widen the drainage pathways, infection may recur frequently, interfering with comfort and good quality of life. The endoscopic sinus surgery process involves the use of a small fiber-optic telescope. This tiny tube-like instrument can access the sinus cavities through the nostrils and remove mucus membranes or protrusions that are inhibiting proper drainage.

The endoscopic sinus surgery procedure is usually performed on an outpatient basis. Patients may receive general or local anesthesia, both of which effectively manage comfort throughout the procedure. After inserting the fiberoptic telescope through the nose, the doctor can observe the sinuses and drainage pathways on a screen. Using special instruments on the endoscope, the doctor carefully widens the pathways by adjusting or removing the structures that are narrowing them. Depending on the type of anesthesia the patient receives, they may remain in the recovery area for an hour or so after their procedure. When released, they should be driven home by a loved one and should take it easy for the remainder of the day.

How Long Does Endoscopic Sinus Surgery Take?

Procedures can take between 1 and 3 hours, depending on the condition the patient has and the techniques that must be employed to correct them. The doctor should have an idea of the details of the procedure after their consultation and observation of images or other diagnostic tests. These details are discussed during the consultation, with the caveat that the endoscopy may be the primary way of discerning how to widen the nasal and sinus passages. Utilizing the images received from the endoscope during the FESS procedure, the doctor then determines what is needed to alleviate chronic sinusitis. This may involve polyp removal, tissue removal, or other techniques.

Recovery and Aftercare for Endoscopic Sinus Surgery?

Patients who undergo endoscopic sinus surgery can expect minor bleeding from the nose for a day or two following the procedure. The nose may be packed to help prevent this or keep it to a minimum. It is common for patients to feel more fatigued than normal for up to two weeks after endoscopic sinus surgery. This may be influenced by the physiological response to surgery as well as the use of prescription pain medication. Congestion is also a common sensation that should resolve in one to two weeks.

Patients receive detailed postoperative care instructions before their procedure. These should be reviewed ahead of time so any questions can be answered. It is important to strictly adhere to the postoperative guidelines to reach the most successful outcome from endoscopic sinus surgery. Following the procedure, the patient may be scheduled for a series of postoperative visits depending on the extent of their procedure. At each, the doctor may observe the condition of the sinuses using nasal endoscopy. Throughout the healing process, the patient may be advised to perform sinus irrigation using saline or prescribed medication. This step is taken to prevent infection and help wash away blood that may have accumulated and dried in the sinuses.

How Long will the Results of my Endoscopic Sinus Surgery Last?

Multiple studies suggest that endoscopic sinus surgery can achieve long-term results for most patients. Many patients report continued symptom improvement compared to pre-surgery after one or more years. That said, there are several factors that may contribute to recurrence, including the patient’s general health, work environment, comorbid conditions, and the normalization of the sinus cavity after the endoscopic procedure. If you are considering endoscopic sinus surgery to improve your breathing and well-being, talk to your doctor about their anticipated outcome and how you may extend the results of your procedure.

How Safe is Endoscopic Sinus Surgery?

Although a minimally invasive procedure, endoscopic sinus surgery does have some associated risks. The chance of complication is very low, but patients are made aware of what they are and how they would be addressed if a complication did arise. Some of the risks of endoscopic sinus surgery include:

• Bleeding. This post-surgical complication generally resolves with or can be prevented by nasal packing.
• Recurrence.  Endoscopic sinus surgery can successfully reduce the symptoms of chronic sinusitis, but it may not eliminate the problem altogether. Patients may continue to need their sinus medications even after treatment.
• Excessive tearing. This complication from sinus surgery is uncommon. Cases in which it has occurred usually resolve in time without additional treatment.
• Damage to the eye or optic nerve. This risk exists due to the proximity of the sinuses to the eyes. Damage to the eye is a very rare occurrence.

Patient Testimonials

“Dr. Martinez was wonderful with my 17 year old son. He asked questions and gave us several options for treatment. We had a wonderful experience with this office. This was our second visit in a year and both times we had great service. I would highly recommend!”

– D.B.

“Dr. Thrasher is a great doctor. Very helpful and easy to understand. Nice, friendly staff.” –

B.Z.

Schedule a Consultation

If you are suffering from Chronic Sinusitis problems and would like to find out if endoscopic sinus surgery is the best option for you, call our practice today at 972.984.1050 to schedule an evaluation. ENT & Allergy Centers of Texas serves McKinney, Plano, Allen, Celina, Frisco, Carrollton, and surrounding areas in Texas.