What is functional endoscopic sinus surgery (FESS)?

Sinuses are air chambers in the facial bones and skull that connect to the nasal passages. Sinusitis is an infection in these areas, and is often due to the connections between the sinuses and nose swelling shut.  Functional endoscopic sinus surgery is a technique using telescopes in the nose to open these passages to promote sinus ventilation and drainage. This helps the sinuses become less susceptible to future infections.

Who qualifies for sinus surgery (FESS)?

Children who experience frequent sinus infections (six infections/year) needing antibiotics or chronic, unresponsive sinus infections are the most common candidates for this type of surgery.  These children have often had their adenoids previously removed without improvement.

Other children with more complicated conditions are frequently seen within this practice as well (examples include cystic fibrosis, fungal sinusitis, immune deficiency, and ciliary dyskinesia). This population is often treated in a multidisciplinary fashion.

How is sinus surgery performed?

Sinusitis is often evaluated with CT scan imaging to determine which sinuses are involved and to what degree.  CT data can also be used in conjunction with a specialized computer navigation system to localize specific areas in the sinuses during complex procedures.

FESS is performed under general anesthesia. The primary goal with this procedure is to open the blocked passages between the nose and sinus cavities in the skull.  This is done under direct visualization with telescopes in the nose. Proper visualization and technique also reduces the risk of damage to the surrounding structures (eye, brain).  Cultures taken during surgery are often used to direct postoperative antibiotic therapy. Children often are discharged a couple of hours after the procedure, with light activity recommended for the following 1-2 weeks.