What is Functional Endoscopic Sinus Surgery (FESS)?
The introduction of high-quality nasal endoscopes has markedly improved intraoperative visualization by the intranasal route. Trauma to normal structures, and hence postoperative morbidity is minimized and precise meticulous surgery to restore physiologic routes of drainage and re-establish ventilation is possible. This is in stark contrast to non-endoscopic intranasal procedures where there is a lot of blood loss and damage to the normal structures causing a lot of scar tissue and poor functional results. Since the FESS techniques have been standardized external approaches to the sinuses are rarely done these days. Practically however, the limited field of view may create disorientation unless the surgeon has developed an intimate knowledge of the anatomy. Hence the surgeon needs to be trained specifically in endoscope and instrument handling techniques in such confined spaces. FESS techniques have proven to be far superior to other conventional modalities of treatment followed earlie
The term “sinus surgery” incorporates a broad array of procedures, ranging from surgery to remove cancer, to the removal of nasal and sinus polyps, to procedures designed to clear and help prevent sinus infection. The vast majority of patients having sinus surgery undergo “functional endoscopic sinus surgery,” or FESS. The surgery is “functional” in that efforts are made and special techniques are used to try to maintain or restore normal sinus anatomy and to help the sinuses function normally. “Endoscopic” surgery is done with small instruments and cameras that go through the nostrils, as opposed to making an external incision or simply looking in and working through the nostrils with a special light mounted to the surgeon’s head.
