What Is FESS?

Functional Endoscopic Sinus Surgery (FESS) is a procedure used to open blocked sinus passages and restore normal drainage. It is performed using a thin camera (endoscope) inserted through the nose, so there are no external incisions or visible scars.

Why Is Surgery Needed?

FESS may be recommended for persistent sinus problems, including:

• Chronic sinus infections
• Nasal blockage or congestion
• Facial pressure or pain
• Nasal polyps
• Reduced sense of smell

Surgery is typically considered when medical treatments (such as nasal sprays, antibiotics, or steroids) have not provided sufficient relief.

Goals of Surgery

The goals of FESS are to:

• Open natural sinus drainage pathways
• Remove blockages (inflamed tissue or polyps)
• Improve airflow and sinus function

These changes help restore normal sinus drainage and reduce infections.

How the Procedure Is Performed

• Performed under general anesthesia
• An endoscope is inserted into the nose
• Specialized instruments are used to open and widen sinus openings
• Blocked or inflamed tissue may be removed
• No external incisions are required

The procedure typically takes 1–2 hours, depending on the extent of surgery.

What to Expect After Surgery

• Most patients go home the same day
• Nasal congestion and mild pressure are common
• Light bleeding or drainage may occur for several days
• Nasal packing or spacers may occasionally be used

Recovery

• Most patients return to normal activities within about 1 week
• Avoid heavy lifting, strenuous activity, and nose blowing for 1–2 weeks
• Saline rinses are essential for healing and hygiene
• Follow-up visits are required for cleaning and monitoring

Benefits of FESS

Many patients experience:

• Improved nasal breathing
• Fewer sinus infections
• Reduced facial pressure
• Improved sense of smell
• Better overall quality of life

Risks

FESS is generally safe, but potential risks include:

• Bleeding
• Infection
• Scar tissue formation
• Persistent symptoms
• Rare complications involving nearby structures (eye or brain)

Sinus Surgery Instructions

Before Surgery

• Surgery is typically outpatient
• Arrange for someone to drive you home
• Do not eat or drink after midnight before surgery

After Surgery

Bleeding

• Light red drainage is normal for 3–6 days
• Change gauze dressing as needed (may be frequent in first 24 hours)
• It can be common to change the gauze 12-24 times in the first 24 hours

If bleeding increases:

1. Perform a saline rinse
2. Blow your nose to remove clots
3. Use 4 sprays of OTC Afrin (or decongestant spray) in each nostril every 4 hours as needed
4. Pinch the nose closed firmly for 20 minutes

Packing

• Packing is not usually used
• Some absorbable packing may be placed and does not require removal
• Avoid forceful nose blowing
• Temporary bad breath or mild odor can be normal

Medications

• Pain or pressure is common; use prescribed medications
• Antibiotics and saline sprays may be prescribed
• Resume oral allergy medications the day after surgery
• Resume medicated nasal sprays after 3 days

Activity

• Avoid swimming and strenuous activity for 5–7 days
• No swimming in contaminated water (lake, pond, ocean) for 4 weeks
• No lifting over 10 pounds or heavy straining for at least 5 days

Diet

• Resume normal diet as tolerated
• Avoid alcohol while taking medications

Saline Irrigations

• Begin 6 hours after surgery
• Perform 4–5 times daily until first follow-up
• Then continue 2–3 times daily for at least 4 weeks

Options:

• Over-the-counter saline kits (e.g., NeilMed)
• Homemade solution: 1 teaspoon salt in 1 quart warm water

Follow-Up

• Appointment typically scheduled 7–10 days after surgery
• Nasal endoscopy with cleaning (debridement) will be performed
• Contact the surgery coordinator if unsure about your appointment

When to Contact Your Doctor

• Excessive bleeding not controlled with the above measures
• Double or blurred vision
• Eye pain or difficulty moving/closing the eyes
• Fever above 102°F not responding to Tylenol or Motrin

Emergency Room Guidelines

• If you need to go to the Emergency Room, please use the following guidelines
• Patients 16 and older: Centennial Medical Center Frisco
• Patients under 16: Children’s Medical Center Plano