Our body consists of small air pockets between the eyes, forehead, nose, and cheekbones. These hollow spaces within the bones are called sinuses. When they get blocked and filled with fluid it leads to inflammation of the sinuses. This condition is termed sinusitis, or as rhinosinusitis, and is usually caused by colds or allergies. Four types of sinuses present in the human body are ethmoid sinus, frontal sinus, maxillary sinus, and sphenoid.
Mild to severe inflammation of the sinuses can affect natural breathing or may cause severe discomfort. When the inflammation doesn't go with medication, surgery is the only option. The sinusitis can be acute, which may last for about two to six weeks while in some cases it can last for more than three months. Functional Endoscopic Sinus Surgery or FESS is considered the most effective treatment method to treat chronic sinusitis and improve sinus ventilation and avoid further complications. The ENT specialist uses minimal invasion to treat the blocked sinuses thus removing any obstruction such as polyps, mucus, and affected tissues to restore normal breathing. If the cause of sinusitis deviates septum, then the surgeon may perform a septoplasty along with FESS.
An ENT specialist advises FESS when the medications are ineffective against the problem. This usually occurs when the mucus obstructs nasal passage encouraging bacterial or viral infections to develop inside the cavities. There are several tests to determine inflamed sinuses. Some diagnostic tests include:
- Images from CT scans, and X-rays that display any inflammation, blockage, or deviated septum that can be the primary cause of obstruction.
- Tests for existing allergies and possible allergens that can be responsible for nasal flare-ups
- Nasal endoscopy to observe any polyps, tumors, or deviation in the nasal septum
- Nasal and sinus discharge samples via swab test to determine any bacterial or fungal infection as the primary cause of sinusitis
What Does FESS Treat?
You may have to undergo FESS for the treatment of the following:
FESS ensures the removal of several allergens that are responsible for chronic allergies due to long exposure to dust, pollens, and pollution that may have blocked your sinuses causing inflammation and even hay fever.
Nasal polyps are abnormal tissue growth in the nasal passage that obstructs the natural airflow. Nasal polyps may occur due to the accumulation of mucus when inflammation in the sinuses has been chronic and hasn't become better with medication. FESS can successfully remove nasal polyps that aid a better nasal flow.
Respiratory Tract Infection
Several bacterial and viral infections in the respiratory tract can occur when the nasal cavity is blocked resulting in inflammation and thickening of the sinus membrane. FESS can help treat these viral and bacterial infections.
How Is FESS Done?
FESS procedures are usually done under general anesthesia and the patient can go home the very same day. The procedure can last from 1 to 4 hours, depending on the patient’s health condition. In the FESS procedure, the surgeon uses a magnifying endoscope to see the affected tissue and bone. A surgeon inserts an endoscope into the nasal cavity through a nostril to remove bone, diseased tissue, or polyps that may be blocking the sinuses. Sometimes, they may also use a small rotating burr to scrape out the tissues. Post-surgery, temporary nasal packing is placed in the nose to provide support to the newly opened sinus passages and to absorb excess fluid. The recovery time depends on the type of sinus surgery taken (such as ethmoidectomy, maxillary antrostomy, or septoplasty) and the condition of the patient.
Why Is FESS Surgery Important?
When the nasal blockage does not respond to medication, FESS becomes an important and the only alternative. Untreated sinusitis can create many health problems. Possible complications of prolonged sinusitis may include the following:
Mastoiditis- Inflammation of the mastoid bone that is present in the head behind the ear.
Brain Abscess- When the bacterial or fungal infection enters the brain tissues causing a pus-filled swelling.
Orbital Abscess - Untreated sinusitis that results in the accumulation of pus within the orbital soft tissue.
Orbital Cellulitis - An infection and inflammation of the muscles around the eye which affects eyelids, eyebrows, and cheeks.
Maxillary Osteomyelitis- An inflammation of the maxillary sinus bone that begins as infection and causes complications.