Functional endoscopic sinus surgery This procedure is used to treat chronic sinusitis and remove benign nasal tumors, and is also performed with the aim of widening the nasal drainage pathways of the sinuses and improving ventilation, learn more about this procedure in Turkey, and how to prepare for it.
Why is sinus surgery performed?
Chronic sinus infections are usually treated with medication rather than Functional endoscopic sinus surgery.
However, Functional endoscopic sinus surgery may be necessary when these infections are recurrent or persistent.
Functional endoscopic sinus surgery is commonly used to treat chronic sinus infections, but it may be necessary for other sinus issues.
Functional endoscopic sinus surgery involves widening the openings between the sinuses and inside the nose to improve ventilation of the sinuses and help mucus escape into the nose.
He was also able to remove sinus tissue, bone, or benign tumors during Functional endoscopic sinus surgery.
Functional endoscopic sinus surgery is a modern technique that minimizes postoperative bleeding, is less invasive than traditional sinus surgery and requires less recovery time.
Sinus surgery types
- Functional endoscopic sinus surgery (FESS): This is the most common type of sinus surgery. It can be performed on an outpatient basis. This is done using a special telescope that is inserted into the nose through the nostril (telescope) to see the inside of the nose and the entrance to the sinuses.
Other instruments are then used through the same nostril to perform the procedure. - Image-guided sinus surgery: In this procedure, sinus surgery is often performed with an image-guided system that uses computerized tomography (CT) to help the surgeon identify anatomical structures and remove as little nasal tissue as possible. This system helps the otolaryngologist know when to approach the edge of the sinuses and thus ensure the safety of the sinuses.
What is Functional endoscopic sinus surgery (FESS)?
Functional endoscopic sinus surgery differs from traditional sinus surgery, using an endoscope that is inserted into the nose to view the nasal cavity and sinuses. This eliminates the need for the external incision used in traditional sinus surgery.
Nasal endoscopy allows for better visualization of diseased structures and helps the surgeon to remove them.
This scope, along with detailed X-ray studies, may reveal a previously unseen issue.
Another difference is that functional endoscopic sinus surgery focuses on treating the underlying cause of the issue.
The ethmoid regions are opened, allowing visualization of the maxillary, frontal, and sphenoid sinuses.
The sinuses can then be visualized directly, and diseased or blocked tissue can be removed if necessary.
So there is often less removal of normal tissue, and functional endoscopic sinus surgery can often be performed on an outpatient basis.
When is functional endoscopic sinus surgery used?
Functional endoscopic sinus surgery is generally performed for people with chronic sinusitis who do not respond to medical treatment.
The diagnosis of chronic sinusitis should be based on the evaluation of an ear, nose, and throat doctor, as other issues can cause symptoms similar to those found in chronic sinusitis.
Most people with sinusitis do not need surgery.
Symptoms of sinusitis can be treated pharmacologically with antibiotics, other medications, and allergy treatment. The type of drug therapy used depends on the evaluation of your ENT doctor.
However, surgery is sometimes required to treat sinusitis. This may be because antibiotics or other medications do not adequately treat the inflammation.
or the symptoms continue to return when antibiotics are stopped, or for other reasons.
You should discuss the need for sinus surgery with your doctor. The decision to have sinus surgery is based on your health history and physical examination.
At the initial consultation, it is important to bring your records from your doctor, including your health history and the sinus treatment used up to this time. If a CT scan or MRI is available, it should also be brought to your first visit to the hospital. A CT scan is also required to accurately assess the areas involved. If you do not do this before your visit, you will need to do it at a later date.
Your ENT doctor suggests starting with drug treatments to see how you respond to maximum drug therapy before deciding on a surgical procedure.
If functional endoscopic sinus surgery is an option for you, your consent will be obtained, and a date for the procedure will be arranged.
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How long does functional endoscopic sinus surgery take?
Functional endoscopic sinus surgery varies in duration depending on the complexity of the case and the procedures required. The procedure can take anywhere from 60 minutes to several hours, depending on factors such as the number of sinuses requiring surgical intervention, the severity of inflammation or cartilage growths, and any other surgical interventions that may be necessary. Overall, Functional endoscopic sinus surgery is generally considered a relatively simple procedure and is often performed successfully and safely.
How do I prepare for functional endoscopic sinus surgery?
- Before functional endoscopic sinus surgery, you will need to have some blood tests and possibly other studies such as an EKG and chest x-ray, which are ordered if your age or medical history indicates the need.
- Oral decongestants (or increase the dose if you are already taking them) and/or antibiotics are sometimes started before functional endoscopic sinus surgery. Take these medications as directed by your doctor. If you have a significant increase in sinusitis in the week(s) prior to surgery, let your doctor know. You may need to postpone your sinus surgery.
- Don’t take aspirin or salicylates for at least 10 days before endoscopic sinus surgery. Aspirin, even in small amounts, can significantly increase bleeding during and after endoscopic sinus surgery.
- Don’t take non-steroidal anti-inflammatory drugs (ibuprofen, Advil, Motrin, Aleve) for at least five days before endoscopic sinus surgery. These medications will also increase bleeding, although their effect on the blood is shorter.
- Don’t smoke for at least three weeks before endoscopic sinus surgery. Smoking not only worsens sinus symptoms, but smoking in the weeks before or after the procedure leads to hypertrophic scarring and may lead to failure of the procedure.
- Don’t eat or drink anything after midnight the night before functional endoscopic sinus surgery.
You should get a nasal spray from a pharmacy and spray it in your nose one to two hours before the endoscopic sinus surgery.
What will happen during functional endoscopic sinus surgery in Turkey?
Functional endoscopic sinus surgery is performed under general or local anesthesia, under the supervision of a specialist physician.
If you choose to have functional endoscopic sinus surgery under local anesthesia, you will be given medications to make you sleepy and relaxed, and you will be provided with some music through a headset. You will usually hear some noises when the bones are removed, which may seem loud to you.
You may also feel some mucus or blood in the back of your throat that you have to swallow. You will be able to talk to your doctor during endoscopic sinus surgery, so let us know if anything is bothering you. If you feel uncomfortable during the procedure, you will be given general anesthesia. In some cases, it may be necessary to repair the nasal septum during endoscopic sinus surgery.
Side effects of functional endoscopic sinus surgery
Complications of functional endoscopic sinus surgery are not common, but your ENT doctor and anesthesiologist will talk about them with you. So be sure to ask any questions you have. Complications may include the following:
Bleeding after surgical treatment
Although the risk of bleeding seems to have decreased with the functional endoscopic sinus surgery technique, sometimes severe bleeding may require termination of the procedure and placement of nasal tampons. Bleeding after endoscopic sinus surgery may require nasal packing and hospitalization. But a blood transfusion is rarely necessary.
Blood transfusion
In the rare cases where a blood transfusion is necessary, there is a risk of an adverse reaction or an infection transmitted through the blood.
Cerebrospinal fluid (CSF) leak
All ethmoid sinus surgeries carry a rare chance of causing a leak of cerebrospinal fluid (the fluid that surrounds the brain).
The risk of CSF leakage is generally higher when the ethmoid sinus surgery is performed through the nose rather than through an external incision.
However, since the endoscope used allows for better visibility, the risk of this complication is likely to be reduced.
If this rare complication occurs, it creates a potential pathway for infection, which can lead to meningitis (inflammation of the brain). A cerebrospinal fluid leak may prolong your hospital stay and may require more surgery to repair.
Visual problems
Although extremely rare, there are reports of vision loss after endoscopic sinus surgery. In addition, temporary or prolonged double vision after endoscopic sinus treatment has been reported in some patients.
Risks of general anesthesia
Because endoscopic sinus surgery is usually performed under local anesthesia, adverse reactions are uncommon. But if general anesthesia is required, you’re exposed to occasional, potentially serious risks. You can discuss adverse reactions to general anesthesia with your specialist.
Risks of septum reconstruction (correction)
During the repair, the patient may experience numbness in the front teeth, bleeding and inflammation of the septum or a hole in the septum, and a hole in the septum may cause difficulty in breathing. Since the cartilage in the septum has a “memory”, it may move after reconstruction and result in a renewed deviation. There is also a small risk of a change in the shape of the nose.
Reduced sense of smell after endoscopic sinus surgery
Permanent loss or reduction in the sense of smell can occur after endoscopic sinus surgery. However, it has already decreased in a number of patients before surgery, and usually improves with surgical intervention.
Other risks
Functional endoscopic sinus surgery can result in chronic sinusitis that does not improve. The patient may feel numbness or discomfort in the upper front teeth for a period of time. Temporary swelling, bruising, or numbness of the lip may occur, as well as swelling or bruising around the eye. Slight changes in voice are also common.
What happens after functional endoscopic sinus surgery?
Some bloody nasal discharge may occur for about two weeks after the procedure; this is normal and improves slowly. You should not blow your nose for at least four to seven days after endoscopic sinus surgery.
As normal sinus drainage returns, you may produce some thick, bloody mucus. This is also normal.
Revision visits are usually arranged around one to six days after endoscopic sinus surgery to clean the nasal crusts and remove any inflammation or scar tissue under local anesthesia. Although the chances of complications from these procedures are rare, the potential risks are the same as with the surgery itself.
Careful postoperative care is essential to the success of this surgery. You will be provided with a booklet of postoperative care instructions. It’s very important that you follow these instructions, as well as any additional instructions we give you, to promote healing and minimize the chance of complications.
The patient should be able to return to their daily routine several days after sinus surgery.
He may experience a crusty or stuffy nose for several weeks after the procedure. For the first few days, the gauze placed under the nose may need to be changed.
Recommendations include sleeping with your head elevated and drinking plenty of fluids. If necessary, he or she may prescribe pain medication or antibiotics. The patient will also be asked to schedule follow-up visits with an ear, nose and throat doctor to make sure the sinuses are healing properly and to clean out any excess blood or mucus.
It is important not to blow your nose when recovering from sinus surgery. This can cause excessive bleeding.
Will functional endoscopic sinus surgery cure sinus diseases?
As with all sinus surgeries, it is possible that the operation may not cure the disease, or the disease may recur at a later date. If this happens, subsequent surgical treatment may be needed. We should be aware that certain medications must be continued after surgical treatment, especially if allergies or polyps (adenoids) play a role in the sinus disease. This is necessary to prevent the recurrence of the disease. Overall, most patients had significant improvement with the combination of surgery and ongoing drug therapy. We will certainly work with you to achieve this goal.
Recovery from functional endoscopic sinus surgery
Functional endoscopic sinus surgery is an effective treatment for those with sinus issues, but it is only performed in patients who have not responded to medical treatment.
Some people notice an immediate improvement in their symptoms after endoscopic sinus surgery, while for others it may take a few weeks or months. Some patients may require ongoing care even after recovering from endoscopic sinus surgery.
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