Procedures Surgeries - Functional Endoscopic Sinus Surgery

What is Functional Endoscopic Sinus Surgery?

Functional Endoscopic Sinus Surgery (FESS) permits the direct visualization and treatment of various parts of the nasal cavities and sinuses which are otherwise inaccessible surgically. Hirschmann (1903) is considered the father of endoscopy. The most commonly performed technique was proposed by Messerklinger.

What are the indications for Functional Endoscopic Sinus Surgery (FESS)?

Diagnostic indications:

  • Cases of sinusitis, anosmia, nasal obstruction
  • Biopsy of nasal and nasopharyngeal tumours
  • Evaluation of epistaxis of unknown origin
  • Evaluation of cerebrospinal fluid rhinorrhoea
  • To evaluate the nasal cavity after surgery and surgical resections like radical maxillectomy

Therapeutic indications:

  • Chronic sinusitis
  • Antrochoanal and ethmoidal polyposis
  • Cauterization of bleeders in epistaxis
  • Closure of CSF rhinorrhoea leaks
  • Optic nerve de-compression
  • Rhinolith and foreign body removal
  • Intranasal Dacrosystorhinostomy (DCR)
  • Removal of nasal masses such as rhinosporosis and angiofibroma in expert hands
  • Choanal atresia
  • Turbinoplasty
  • As an approach for Trans-Sphenoidal Pitutary tumours removal

What is the aim of Functional Endoscopic Sinus Surgery (FESS)?

The main aim of Functional Endoscopic Sinus Surgery (FESS) is to remove the diseased mucosa only to relieve obstruction and restore natural sinus drainage, physiology and ventilation.

How is Functional Endoscopic Sinus Surgery (FESS) done?

The procedure is usually performed under local anaesthesia with sedation or general anaesthesia in young or uncooperative patients or patients having extensive sinonasal disease.

  • After adequate preparation 0º 4 mm sinoscope, the uncinate process is removed. The maxillary ostium can be inspected using 30º telescope
  • The posterior ethmoidal air cells are approached through the basal lamella. The frontal recess is also visualized 45º scope
  • Beyond the posterior ethmoidal air cells lies the sinus
  • The nose is then packed with vaseline gauge or expandable nasal tamponade.

What are the complications of Functional Endoscopic Sinus Surgery (FESS)?

Major complications:

  • Blindness or loss of vision
  • CSF leak
  • Meningitis
  • Intracranial bleed
  • Damage to the internal carotid artery
  • Vasovagal collapse

Minor complications:

  • Septal or mucosal adhesions
  • Orbital emphysema
  • Epiphora
  • Bleeding

However it must be noted that complications are markedly reduced in skillful hands and with newer good instruments and imaging techniques.



Bombay Hospital and Medical Research Center
201, 2nd Floor, New Wing 12,
New Marine Lines
Mumbai - 400020
Contact Phone No: 91-022-25283707 Contact Mob No: 07715050774

Juvekars Nursing Home
17/18, Shivsagar CHS
Opposite Akbarallys,
Off Sion Trombay Road
Chembur East, Mumbai -71
Tel: +91-22-25271140
+91-22-25271150

For any suggestions. Please mail at: feedback@specialist-ent.com

Topic on Noise Pollutions By Dr.Meenesh Juvekar ON AIR 93.5 Red FM With RJ Malishka


Topic on Coughing By Dr.Meenesh Juvekar ON AIR FM GOLD


Topic on Snoring Problems By Dr.Meenesh Juvekar ON AIR FM GOLD