Functional Endoscopic Sinus Surgery (FESS)
FESS (Functional Endoscopic Sinus Surgery) is a modern, high-tech, and minimally
invasive surgical method for treating various diseases of the paranasal sinuses. Paranasal
sinuses are air-filled cavities in the skull bones that connect to the nasal cavity through
small openings (ostia). Their main function is to warm, humidify, and clean inhaled air, as
well as participate in voice formation. Inflammation, blockage of ostia, or other pathological
processes in the sinuses disrupt their drainage and ventilation, leading to sinusitis
(maxillary, frontal, ethmoid, sphenoid), polyp formation, cysts, and other problems.
The essence of FESS is that all manipulations are performed through intranasal access
using a special thin optical device – an endoscope, equipped with a video camera, and
microsurgical instruments. This allows the surgeon to see all structures of the nasal cavity
and sinuses in detail on a monitor screen, remove pathological tissues (polyps, altered
mucosa, pus), widen the natural sinus ostia, and restore their normal aeration and content
drainage. The main advantage of FESS is the preservation of healthy tissues and
restoration of the natural sinus function without external facial incisions.
Advantages of FESS in Our Clinic
By choosing our clinic for FESS, you entrust your health to experienced professionals and
modern technologies:
• Highly Qualified ENT Surgeons: Our doctors specialize in endoscopic sinus
surgery, have many years of experience, and continuously improve their skills by
participating in international conferences and workshops.
• Advanced Endoscopic Equipment: We use high-resolution video endoscopic
systems and precision micro-instruments, allowing for surgery with maximum
accuracy and minimal trauma.
• Accurate CT-Based Diagnosis: Each surgery is meticulously planned based on
computed tomography data, ensuring an individual approach and predictable
results.
• Functionality and Preservation of Healthy Tissues: The main principle of FESS
is to restore natural sinus drainage and ventilation while maximally preserving
healthy mucous membrane.
• Patient Comfort and Safety: Surgeries are performed under modern general
anesthesia. We provide attentive postoperative monitoring and effective pain relief.
• Comprehensive Approach: If necessary, FESS is combined with other ENT
surgeries (septoplasty, turbinoplasty) to achieve the best results. We also provide
full postoperative patient management..
How is FESS Performed?
FESS is performed in a hospital setting under general anesthesia.
1. Anesthesia: The surgery is performed under general endotracheal anesthesia.
The patient is asleep and does not experience any discomfort.
2. Surgical Stage: The surgeon inserts an endoscope into the nasal cavity. Under
video guidance, using special micro-instruments, they carefully remove
pathologically altered tissues (polyps, hypertrophied mucosa), open affected
sinuses, and widen their natural ostia, restoring drainage and ventilation. Healthy
tissues are preserved as much as possible. The extent of surgery is determined
individually based on CT data and intraoperative findings. In some cases, a
navigation system may be used for greater precision.
3. Completion of Surgery: After all manipulations are completed, special hemostatic
(blood-stopping) nasal packing or self-dissolving materials that do not require
removal may be placed in the nasal cavity. Sometimes, packing is not necessary.
The duration of the surgery depends on the extent of the intervention and can range from
30 minutes to 2-3 hours.
Frequently Asked Questions (FAQ) about FESS
1. How painful is FESS surgery and the recovery period?
The surgery itself is performed under general anesthesia and is completely painless. In the
postoperative period, moderate discomfort, a feeling of stuffiness or pressure in the nose,
and headache are possible. These symptoms are usually well controlled by prescribed
pain medications.
2. How long does FESS surgery take?
The duration of the surgery depends on the extent of the intervention and the complexity of
the case. It can range from 30 minutes (e.g., for a simple maxillary antrostomy) to 2-3
hours (for extensive polyposis or surgery on multiple sinuses).
3. How soon will I be able to breathe normally through my nose after surgery?
Improvement in nasal breathing usually occurs gradually. After removal of nasal packing (if
used), breathing becomes easier, but some congestion due to swelling may persist for 1-3
weeks. Most patients feel significant improvement after 2-4 weeks, and full restoration of
breathing function can take up to several months.
4. Are there any facial scars after FESS?
No. FESS is an endoscopic surgery performed entirely through the nasal passages. No
external facial incisions are made, so there are no visible scars.
5. What is the likelihood of disease recurrence (e.g., polyps) after FESS?
FESS aims to eliminate the cause of the disease and create conditions for normal sinus
function. However, with certain diseases, such as nasal polyposis or allergic fungal
rhinosinusitis, there is a risk of recurrence. The likelihood depends on many factors,
including the type of disease, individual body characteristics, concomitant conditions (e.g.,
bronchial asthma, allergies), and adherence to doctor's recommendations in the
postoperative period (e.g., regular use of prescribed nasal sprays). Regular follow-up with
an ENT doctor helps to detect and manage potential problems promptly.
6. Is special nasal care required after FESS?
Yes, proper postoperative care is very important. It includes regular rinsing of the nasal
cavity with saline solutions, use of doctor-prescribed nasal sprays (often localПРОЦЕДУРЫ / PROCEDURES
corticosteroids to prevent swelling and inflammation), and periodic visits to the ENT doctor
for nasal cavity cleaning (removal of crusts, fibrin).
7. What is a navigation system, and is it used during FESS? A surgical navigation system
is high-tech equipment that helps the surgeon navigate with high precision within the
anatomical structures of the nasal cavity and sinuses during surgery by correlating the
operative field with the patient's CT data in real-time. This enhances the safety and
accuracy of the intervention, especially in complex cases or revision surgeries. Our clinic
may use navigation systems when indicated.