FESS FAQs

Following are the common questions about FESS:

1. What is FESS?
2. Why should I undergo FESS?
3. What do you mean by sinusitis?
4. What are the different types of sinuses present in the human body?
5. What is the role of sinuses in the human body?
6. Who treats sinusitis?
7. What conditions are treated with FESS?
8. What will happen if I prolong the FESS procedure?
9. When should I consult the doctor for sinusitis?
10. How can I prevent sinusitis from progressing?
11. Are there any alternative treatment methods for sinusitis apart from FESS?
12. What are the different diagnostic tests to determine sinusitis?
13. What is the cost of the FESS procedure?
14. When can I resume my daily activities after undergoing FESS?
15. What factors affect the cost of FESS?

Q. What is FESS?

A. FESS or Functional Endoscopic Sinus Surgery is a minimally invasive surgery to treat chronic sinusitis. ENT specialists perform FESS to restore sinus ventilation and normal breathing by removing any obstruction that can result in inflamed sinuses.

Q. Why should I undergo FESS?

A. Functional Endoscopic Sinus Surgery or FESS is considered the most effective treatment method to treat chronic sinusitis. The ENT specialist uses minimal invasion to treat the blocked sinuses and removes any obstruction such as polyps, mucus, affected tissues, etc., to restore normal breathing. If the cause of sinusitis is nasal deviation, then the surgeon can perform a septoplasty alongside the FESS.

Q. What do you mean by sinusitis?

A. Sinusitis refers to the inflammation of the tissue lining or nasal passages in the sinuses that affect the natural breathing of the individual. The sinusitis can be acute, which usually lasts for a duration of about 1-4 weeks depending on the type of infection (bacterial or viral), or chronic which can last for more than 3 months.

Q. What are the different types of sinuses present in the human body?

A. There are four types of sinuses present in the human body in different areas around the face-

• Ethmoid sinus - It is present between the eyes.
• Frontal sinus - It is present behind the forehead.
• Maxillary sinus - This sinus is present behind the cheekbones.
• Sphenoid sinus - This sinus is present under the base of the skull.

Q. What is the role of sinuses in the human body?

A. Healthy sinuses are air-filled pockets that are located behind the forehead, nose, cheekbones, and between the eyes. The sinuses produce a thin and flowing liquid called mucus that keeps the inside of the nose moist and traps the harmful allergens, bacteria, germs, etc., that enter through the nasal cavity.

Q. Who treats sinusitis?

A. If you are experiencing symptoms of sinusitis, you can consult the ENT specialist. An ENT specialist diagnoses and treats conditions related to the ear, nose, and throat. You can consult the ENT specialist if you are suffering from early signs of sinusitis to manage the symptoms in time.

Q. What conditions are treated with FESS?

A. You can undergo FESS if you are suffering from chronic sinusitis or if the medications are ineffective against your sinusitis. This usually occurs when the mucus becomes thick enough to obstruct nasal passage encouraging bacterial or viral infections to develop in the sinus cavities. You may have to undergo FESS for the treatment of the following -

• Allergies - FESS ensures removal of several allergens that are responsible for chronic allergies due to long exposure to pollens, pollution, dust, etc., and block your sinuses causing inflammation and even hay fever.
• Nasal polyps - This refers to the abnormal tissue growth in the nasal passage that obstructs the natural airflow due to the accumulation of mucus. FESS ensures the removal of polyps for better nasal ventilation.
• Respiratory tract infection - Several bacterial and viral infections in the respiratory tract can obstruct the natural airflow and result in inflammation and thickening of the sinus membrane. This can be treated using the advanced FESS procedure.

Q. What will happen if I prolong the FESS procedure?

A. FESS is an advanced procedure to improve sinus ventilation and avoid complications related to chronic sinusitis. There may be major complications related to sinusitis that can progress if FESS is not done in time. Possible complications of prolonged sinusitis include -

• Mastoiditis - It refers to the inflammation or infection of the mastoid bone that is present in the head behind the ear.
• Brain abscess - Prolonged sinusitis can lead to brain abscess, which occurs when the bacterial or fungal infection enters the brain tissues causing a pus-filled swelling in the brain.
• Orbital abscess - Untreated sinusitis can result in the accumulation of pus within the orbital soft tissue, which can be confirmed by the imaging tests.
• Orbital cellulitis - It refers to the infection and swelling of the muscles around the eye, which can gradually become worse. It affects eyelids, eyebrows, and cheeks.
• Cavernous sinus thrombosis - Prolonged sinusitis results in complications that can result in a blood clot in the cavernous sinuses.
• Frontal or maxillary osteomyelitis - Complication of untreated sinusitis can result in frontal or maxillary osteomyelitis. It refers to the inflammation of either the frontal or maxillary sinus bone that begins as an infection.

Q. When should I consult the doctor for sinusitis?

A. Sinusitis can be acute or chronic. Acute sinusitis may not always demand a doctor’s consultation and can be cured with non-surgical treatment methods. Consult the doctor when you experience the following symptoms -

• Chronic headache or sore throat
• High fever (above 102°F or 39°C)
• Pain, swelling, or redness around the eyes
• Thick dark mucous discharge from the nose
• Chronic cough that lasts for more than 10 days
• Sinusitis symptoms persist for more than 1 week.
• A congested or blocked nose that causes difficulty in breathing

Q. How can I prevent sinusitis from progressing?

A. There are several early preventive measures and home remedies that can help reduce the risk of chronic sinusitis and complications associated with it. Some of the preventive measures include the following -

• Use a humidifier - It is important to keep your surrounding air free of any impurities by using a humidifier that can ensure good air quality and clean air.
• Avoid respiratory infections - You must avoid contact with people who are already suffering from cold or other respiratory infections. You can consult with the ENT specialist to manage your symptoms and make sure the infection is under control.
• Be aware of your allergies - It is important to be aware of seasonal allergies and avoid exposure to allergic elements that can often lead to sinuses and other respiratory infections.
• Avoid exposure to polluted air - It is important to avoid frequent exposure to contaminated air, pollution, or cigarette smoke that can cause inflammation in the lungs and nasal passages.

Q. Are there any alternative treatment methods for sinusitis apart from FESS?

A. Yes, there are several non-surgical methods that can help manage the symptoms of sinusitis if the inflammation is caused due to bacterial infections. Some of the non-surgical methods for sinusitis are-

• Antibiotics - A course of antibiotics is very effective for bacterial infections if the course is completed in the given time period. Antibiotics are effective methods to curb the symptoms of sinusitis that are progressive and persistent. However, antibiotics are not the permanent treatment for curing sinusitis. The antibiotics course must be completed even if your symptoms get better.
• Antihistamines - These medications block the inflammation caused due to allergies and are very effective in managing infections caused due to allergies.
• Nasal saline wash - Saline wash or nasal sprays rinses away irritants, allergies to clear thickened or dried secretions in the nasal passage and keep the membrane moist and soft. Nasal saline wash must be done several times a day for an efficient treatment.
• Nasal Decongestant Sprays - These medications help in shrinking the swollen nasal passage for proper drainage of mucus. However, it should be done under medical supervision as these sprays can also cause swelling in the nasal lining.
• Topical Nasal Corticosteroids - These nasal sprays prevent and treat inflammation. Some of these medications include -
  • Fluticasone (Flonase Allergy Relief)
  • Budesonide (Rhinocort Allergy)
  • Mometasone (Nasonex)
  • Beclomethasone (Beconase AQ, Qnasl)
• Immunotherapy - Immunotherapy or allergy shots help reduce the body’s reaction to specific allergens. It is effective in improving symptoms of sinusitis that result in the blockage of the nasal septum.
• Home remedies - Several home remedies can help with acute sinusitis and a blocked nose. Some of the home remedies include -
  • High fluid intake
  • Heat treatment on the nose or forehead
  • Moistening your sinus cavities by breathing in the hot vapor of water.
  • Rinsing your nasal passage by special nasal squeeze bottle

Q. What are the different diagnostic tests to determine sinusitis?

A. There are several tests to determine the condition of your sinuses. These tests include examination by the doctor and some diagnostic tests to determine the full extent of the problem. Some of the diagnostic tests include -

• Imaging tests - Images from CT scans, x-rays pinpoint any inflammation, physical blockage, or deviated septum that can be the primary cause of obstruction.
• Tests for existing allergies - The doctor recommends these tests to determine any allergens that can be responsible for the nasal flare-ups.
• Nasal endoscopy - The ENT surgeon uses a thin, flexible tube that is attached to a fiber-optic light on the other end to observe any polyps, tumors, or deviation in the nasal septum.
• Nasal and sinus discharge samples - The ENT surgeon recommends examination of samples of nasal discharge via swab test. It helps the doctor in determining any bacterial or fungal infection as the primary cause of sinusitis.

Q. What is the cost of the FESS procedure?

A. The cost of FESS usually starts from Rs. 50,000 depending on several factors such as location, medical condition of the patient, selection of hospital, etc.

Q. When can I resume my daily activities after undergoing FESS?

A. You can resume your daily routine 5-7 days after the procedure. However, the recovery time can depend on the medical condition of the patient and the surgical expertise of the surgeon. Full recovery usually takes a month if the patient strictly follows post-operative care.

Q. What factors affect the cost of FESS?

A. The overall cost of FESS can depend on several factors such as -

• Selection of the hospital (government or private)
• Consultation cost of the ENT specialist
• Cost of diagnostic test
• Cost of anesthesia
• Cost of septoplasty (if required)
• Medication cost
• Insurance coverage