What does FESS stand for?

Functional Endoscopic Sinus Surgery. In other words, an operation which restores the natural function of the sinuses.

What are sinuses and where do they lie?

The sinuses are air filled spaces in the skull around the nose. There are two in the cheek bones called maxillary sinuses. Two rest between the nose and eyes. These are known as ethmoidal sinuses. Two are just above the eyebrows in the middle of the forehead. Finally, there are sinuses in the middle of the head behind the nose. These are known as sphenoidal sinuses.

What is the purpose of the sinuses?

some people think that they make the skull lighter. They help with voice resonance, humidification and air conditioning.

What goes wrong with the sinuses?

The sinuses have channels which open out into the nose. Sometimes these channels block and the sinuses stop draining. Pressure build up and infection may occur causing facial pain and a feeling of blockage.

The sinuses may also become filled with polypi. Polypi are whitish grey swellings which are grape like in appearance and are often allergic in origin.

Rarely, the sinuses may be affected cancer.

How do we do the operation?

You come into hospital and it is done under a general anaesthetic. We look into the nose using a fibreoptic ridged telescope. We then have a variety instruments to use to remove the polypi and disease. We also attempt to open up the sinuses to allow air in and disease out.

The operation is sometimes combined with a septoplasty. Some surgeons put packing and plastic splints in the nose. The packing is removed the next morning and you are discharged home with medication.

Recovery

Overnight stay and then two weeks at home. You can expect some bloodstained ooze from the nose for some days. If it bleeds without stopping you should ring the ward and come back to hospital.

Complications

Pain occurs after the operation, but we give you pain killers to help. You can expect some bloodstained ooze from the nose for a few days after the operation, but if bleeding happens you should ring the ward and come back to hospital. Complications with anaesthetics are uncommon nowadays, as they have become increasingly safe. There are also two other complications which are rare, but important ones to be aware of before considering the operation. We use a telescope to look up the nose into the sinuses, but the sinuses and the brain and eyes are very close together. It is possible that the scope may pass through the roof of the nose and enter the brain and its surroundings. This would cause a leak of the clear fluid which surrounds the brain down through the nose. If this happens then infection may go via the same route to cause infection of the surroundings of the brain, otherwise known as meningitis. The other uncommon complication is damage to the eyes, possibly causing blindness.