Sinus Surgery (FESS)
An endoscopic sinus surgery is usually undertaken to bring relief from chronic rhinosinusitis (inflammation in nose and sinuses that’s unrelieved for at least 3 months) that’s not responding satisfactorily to medications. The cause of this inflammation can be anything from infection, allergies and irritants to polyps (non-cancerous swelling of the nasal/sinus lining). Endoscopic sinusitis surgery can be undertaken under local anaesthesia or general anaesthesia.
Another recent sinus treatment technique is to use ballooning to widen sinus openings. This can be done during the sinus surgery or as an in-office treatment depending on the patient and his/her condition.
- Chronic Rhinosinusitis
- For treating nasal polyps, impaired smelling sense, tear duct blockage, brain fluid’s leakage into the nose, recurrent infections (responding to medicines but making a comeback soon after), sinus infections affecting eyes, face or brain, or nasal and sinus cavity tumours of both benign and malignant types.
- Newest developments in the field have enabled sinus surgeons to open surgery pathways to brain and pituitary gland for neurosurgeries and to eye sockets for ophthalmic surgeries.
Why this surgery?
- If sinusitis is not treated it can lead to lot of discomfort and pain.
- If there are other health problems like asthma, along with sinusitis, then the patient’s health might deteriorate.
- In rare cases, not getting sinusitis treated might lead to serious conditions like bone infection, meningitis, or brain abscess.
- Gives relief from discomfort and pain
- Prevents other serious conditions like meningitis, or brain abscess
- Increases the sense of smell by restoring better airflow.
Know more about Sinus Surgery (FESS)
- If the patient is on any blood-thinning medications such as aspirin, ibuprofen, omega 3 and/or vitamin E, they should stop their intake at least a week before the surgery. If prescription blood thinners are required for another medical condition, please get the surgeon to provide guidance on stopping and re-starting them.
- Till the preceding night of the surgery, duly take all medications prescribed by the ENT surgeon. Bring along any medicines, that are being taken currently, both prescribed and non-prescribed, in original packaging while checking in for surgery the next morning.
- Get a good night’s sleep. Have a good dinner but do not eat anything at all from midnight onwards prior to the surgery day.
- Make sure to bring the hospital file at the time of the check-in for surgery duly including all required test reports such as the major surgical profile, pre- anaesthetic check-up sheet, radiological investigation films and reports (X-ray, CT scan, MRI, PET scan etc.) and any others investigations advised by the ENT surgeon. Ge the file ready a day before the surgery.
- The patient should be accompanied by an attendant. It is advised to bring along a close family member.
- Please make sure to report at the hospital at least three hours prior to the surgery’s scheduled timing.
- Report at the reception desk in time and the hospital staff will guide through the next steps.
- If there is any change in physical condition such as cough, cold, fever or throat pain, be sure to mention it to the doctor and anaesthetist.
- If allergic to any drugs, be very sure to mention that as well.
- In the first 24 hours take complete bed rest in the post-operation ward.
- Food or drink is not allowed for 4-5 hours after surgery. After that water is allowed. Caffeinated beverages such as tea, coffee or aerated drinks are to be avoided. Semi-solid diet in moderate quantities is allowed after 12 hours and normal food from second day onwards.
- The nose will be packed after the surgery for 1-2 days and the patient will have to breathe through the mouth. Before discharge though, the hospital staff will remove this packing. Patient will be discharged either on the same day or the next day of the surgery
- On the 10th day from the date of the surgery, you will receive an endoscopic nose cleaning in the Minor Procedure Room.
- Be sure to take all medications on schedule as prescribed by the surgeon.
- Please ensure to spray, the prescribed nasal sprays (5-6 times daily in each nostril) towards the side wall and not the centre of the nose always. Till 2 weeks after the surgery, it is normal to have a ‘stuffy’ feeling in the nose that comes from the swelling caused by the surgery. Pease do not, blow your nose, breathe back forcefully or probe the inside of your nose with finger, as that may cause bleeding.
- Till 2 weeks after the surgery, your nose will secrete blood-stained watery fluid. This is expected and simply needs to be gently wiped using a soft, clean cloth or tissue.
- Stay away from places with dust, smoke, or anything that can cause an allergic reaction to induce excessive sneezing or watering of nose and eyes.
- Abstain from cold foods such as ice creams and cold drinks or any other foods that can cause an allergic reaction to induce excessive sneezing or watering of nose and eyes.
- If a sneeze comes, please open your mouth and sneeze out to protect the nose.
- While regular body bath is allowed post the day of discharge, wait till the doctor gives clearance to have a head bath.
- Protect your nose from pressure by abstaining from heavy lifting, straining, or undertaking any vigorous work for at least 3 weeks after the surgery. Also stay away from contact sports and any activity that can injure the nose.
- Never bend the head below the heart level.
- One can resume office work a week after the surgery. However, if work requires strenuous activity, it is advised not resuming it till two weeks after the surgery.
- The patient will need to come for reviews twice – 10 days after endoscopic nose cleaning for the first review and 10 days after that for the second review.
- If there is any problem in-between or after the reviews, please schedule a visit to the OPD of the hospital.
As with any other surgical procedure, septal and turbinate procedures too come with a few associated risks, though its rare. One should understand the potential risks and clarify their concerns from the surgeon well in advance.
- Bleeding: Some degree of bleeding is expected in nasal surgeries. Very rarely, significant bleeding may require termination of the procedure. Blood transfusion in a nasal surgery is rare and is strictly an emergency measure.
- Blood clot: If post-operative bleeding leads to a blood clot or hematoma within the septum, the surgeon will need to remove the clot which can cause scar tissue formation or even nasal collapse.
- Voice changes: Sinuses’ role in the body includes lending resonance to the voice. Those in voice-related careers (VO artists, actors, singers etc) should be aware that an endoscopic sinus surgery can bring subtle changes in their voice.
- Smell and taste impairment: In rare cases, sense of smell can weaken due to persistent swelling, allergy or infection. Most of the times, any impairment in senses of smelling or tasting is a temporary phenomenon but, in a few cases, it may be prolonged.
- Nasal obstruction, dryness and pain: Enlarged turbinates are often responsible for nasal congestion. Their size reduction in a surgery usually clears up this problem but, in some patients, a sensation of high dryness can strike persistently. Some patients can even get chronic pain. In rarest cases, this can become a severe problem referred to as ‘the empty nose syndrome.’
- Infection: A sinusitis patient undergoing a sinus surgery is at risk of developing certain other infections such as abscesses or meningitis etc from sinus surgery. It may sound paradoxical but this is also a possible complication if the patient chooses not to undergo a sinus surgery for a severe or refractory chronic sinus infection.
- Intraorbital complications (damage to the eye or surrounding tissue): The eye is in close proximity to paranasal sinuses and separated from them by a thin layer of bone. In rare cases, bleeding into the orbit can start that needs immediate treatment. In rarest of rare cases, this bleeding can even lead to blindness. Another rare problem is temporary or permanent damage to the muscles responsible for eye movement leading to double vision. Again in some rare cases, the function of the tear ducts can get upset and cause excessive tear formation.
- Intracranial complications: As the top of the nasal septum is attached to the floor of the brain, a leak of cerebrospinal fluid into the nose can occur in case this thin bony layer breaks. In rarest of rare cases, this problem can create a potential pathway for bleeding into brain, or infections such as meningitis requiring additional surgery and hospitalization.
Why Dr Rao’s ENT?
Best Success Rate – Sinus Surgery (FESS) when conducted by expert surgeon delivers very successful outcomes.
World Class Technology
- HD Endoscopes – Provides precise visualisation. Ensures minimal invasive surgical procedure.
- Zeiss Vario Microscope (Germany) – Brings neurosurgical precision to ENT surgeries.
- Lumenis AcuPulse DUO with complete ENT accessories (USA) – Customised beam delivery for superior clinical results and improved patient safety.