Functional Endoscopic Sinus Surgery (FESS)

Paranasal sinuses are air-filled cavities in the cranial bones lined with the mucous membrane. They have several important functions: cleaning and heating the inhaled air, reducing the weight of skull bones and even modulating the sound of our voice.
Sinuses are connected with the nasal cavity through narrow canals, called sinus ostia. In healthy sinuses the produced mucus is transported through the ostia to the nasal cavity and then down to the throat, where it is swollen. We do not notice this process.

If there is an inflammation in the sinuses, their ostia are blocked due to the swelling of the mucous membrane. As a result, mucus builds up in the sinus region, which creates conditions conducive to bacterial infection. The most frequent symptoms include: nasal congestion, problems with blowing the nose, feeling of facial ‘tightness’, headaches. Sinusitis is often accompanied by chronic rhinitis and thick discharge dripping down the back of your throat, causing you to cough. Patients may also lose their sense of smell, partially or completely. In acute sinus infections, high fever may occur.
An acute sinus infection requires the attention of an ENT doctor and is treated with specially selected antibiotics, nasal steroids and ancillary medications.
In some cases, when the infection does not respond to treatment, symptoms become chronic and a surgery is necessary.

• precise opening of the ostia,
• minimally invasive procedure, which leaves intact the anatomical structures which are not affected by the infection,
• less painful procedure,
• shorter hospital stay,
• sinuses are cleaned from infection lesions without any additional incisions in the face region.

If sinus infection symptoms persist despite pharmacological treatment, an endoscopic examination of the nose should be done to evaluate the condition of the nasal cavity and sinus ostia. In each case a computed tomography scan is also necessary, as it helps to precisely evaluate the condition of the sinuses and to plan the surgery.

• Two weeks before the procedure you should have the following blood tests done: full blood count, electrolyte test, coagulation test, blood type, glucose, creatinine, Hbs antigen, ANTI-HCV.
• If you have other medical conditions, please provide a certificate from a relevant specialist that there are no contraindications to the procedure.
• Seven days before the surgery you should discontinue anticoagulants.
• You should not eat or drink anything for 6 hours before the procedure.

The surgery is performed under general anaesthesia. A doctor uses a set of endoscopes with a visual tube, thanks to which the image from the endoscope is enlarged and projected on the screen in HD quality. Using suitable instruments the doctor removes the infected mucous membrane and bone fragments blocking the sinus ostia and any lesions within the sinus region. If sinus ostia are unblocked, the sinus infection usually resolves by itself soon after the procedure.

Immediately after the procedure you may feel that your nose is congested due to the nasal packing (type of dressing) in the nose. In most cases the packing is removed 24 hours after the procedure.