Endoscopic Sinus
Surgery
Functional Endoscopic Sinus Surgery (FESS) is a procedure described by Dr. Messerklinger of Austria in the mid-1980s and spread to the rest of the world.
FESS is advised for individuals who have failed medical treatment for chronic sinusitis.
Sinus surgery was previously performed through external incisions (surgical cuts on the face and in the mouth), required extensive nasal packing (gauze or other material placed in the nose to control bleeding after surgery), caused significant pain and discomfort, and was frequently followed by a lengthy recovery period.
With recent technological developments, such as the nasal endoscope, sinus surgery is now often performed totally via the nose, with no face or mouth incisions. The nasal endoscope is a tiny, illuminated metal telescope that is inserted into the nostril. With a high-resolution video camera linked to the endoscope, the surgeon can view within the nose and sinuses.
Endoscopic sinus surgery is now commonly performed with minimum to no nasal packing, moderate discomfort, and quick recovery times.
The most prevalent reason for endoscopic sinus surgery is “chronic rhinosinusitis,” often known as “chronic sinusitis.” Chronic rhinosinusitis refers to inflammation (swelling) of the nose and sinuses that does not respond adequately to medical therapy.
Recurrent infections, sinus infections that extend to the eye, face, or brain, nasal polyps, tumors of the nasal and sinus canals, leaking brain fluid into the nose, and tear duct obstruction are some of the less usual causes for sinus surgery. Furthermore, new improvements in endoscopic sinus surgery allow your sinus surgeon to access parts of the brain and pituitary gland for neurosurgeons, as well as the orbits (eye sockets) for for certain ophthalmology procedures.
Is Fess Good For Me?
If medical treatments have not been successful in improving your sinus symptoms, endoscopic sinus surgery may be helpful. The goal of the surgery is to identify the narrow channels that connect the sinuses to the nose and enlarge these narrow openings/channels. Surgery is not a cure for sinusitis but is one of the many critical steps in managing sinus disease. Most patients who have endoscopic sinus surgery do very well, with significant improvement in their symptoms. Nasal packing is not frequently used, however, ethmoid stents coated in antibiotics and steroids are frequently used.
The recovery period will vary depending on the individual, but most patients require 1 to 2 weeks off work. Most patients will be required to irrigate with saline spray three times daily after surgery.
Ballon Sinus Dilation
A study named CLEAR for Clinical Evaluation and Efficacy of Balloon Sinus Dilation. Chronic sinus sufferers were enrolled from several centers throughout the U.S. and Australia in 2005. 115 patients were followed for a minimum of 6 months after undergoing balloon sinus dilation. There were no complications or injuries to any patients enrolled in the study. A nontraumatic, flexible guidewire with a lighted tip is used to visualize proper placement of the balloon across the sinus opening.
In-office balloon sinus dilation utilizes the same tools and techniques as in the operating room; however, patients are now fully awake. In this situation, the balloon is guided into the blocked sinus passageway with the use of a navigation system for the sinuses. This has eliminated the need for fluoroscopy and made the procedure even safer for our patients.
Computer Guided Sinus Surgery And Skull Base Surgery
The term “image-guidance” refers to the use of a probe or instrument, that is tracked by a machine as that probe moves through the nose and sinuses. This map is provided by a specialized CT scan which is performed prior to your surgery. The overwhelming agreement among expert rhinologists is that image guided surgery makes many surgical procedures safer and more complete. Please discuss with your surgeon to see whether you would be a candidate for computer guided surgery.