What is it?
Most infections of the larger sinuses in our face result from the spread of infection from the ostio-meatal complex (OMC), a key area in the lateral wall of the nasal cavity. With the fibreoptic endoscope and computed tomographic (CT) scan, your doctor is able to assess and treat paranasal sinus disease. The endoscope enables your doctor to look at the OMC and identify possible anatomical obstruction or nasal polyps that may predispose to sinus disease.
In Function Endoscopic Sinus Surgery (FESS), minimally invasive surgery is performed on the key areas with the aid of an endoscope. Existing obstruction is removed and sinus ventilation and function can then be restored to normal.
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Do I need it?
Your doctor has advised you to have functional endoscopic sinus surgery for one or more of the following reasons:
a. Chronic or recurrent sinus infection despite antibiotic and other therapy
b. Complicated acute sinus infection
c. Nasal polyps and
d. Variation in the nasal anatomy causing obstruction at the OMC.
In general, FESS yields excellent results in 80% of patients. The remaining 20% may expect an improvement of their nasal symptoms and may often benefit from minor revision surgery.
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How do I prepare?
Your doctor will enquire about your general health and assess your fitness for surgery.
Inform your doctor if:
a. You or your immediate family has had any problems with anesthesia
b. You are taking medication or have used steroids in the past year
c. You have a bleeding disorder
d. You have sickle cell anemia
e. You are pregnant or
f. You have concerns about the transfusion of blood.
Selected blood tests and possibly a Chest X-ray and Electrocardiogram (ECG) may be required prior to surgery.
You should not take aspirin, or medications containing aspirin, for at least 2 weeks before the surgery.
If you get an upper respiratory tract infection (URTI) or fever during the five days prior to surgery, please inform your doctor. Your doctor may need to reschedule the surgery as an URTI may increase the risk from anesthesia.
Do not eat or drink after midnight before your surgery. This restriction includes water. The contents of the stomach may be vomited during induction of anesthesia and this is dangerous.
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What to expect
The procedure will take usually take less than an hour. You will be under anesthesia during the entire surgery. Intravenous fluids will be given during and after surgery. The procedure will be done through the nostrils and no external scar will be seen. A nose pack (sponge dressing) will be inserted after the surgery into each nostril to soak up any blood.
You will then be taken to the post-anesthesia care unit where the nursing staff will observe you until you are discharged.
Your response to the surgery will vary according to the length and type of anesthesia and the surgical procedure. Many patients may have FESS performed as an outpatient procedure. Others may require an overnight stay.
You may experience temporary post-operative symptoms. These include:
a. Drowsiness and nausea
b. Headache
c. Sinus or nasal discomfort, and
d. Blood stained discharge from the nose for 3 to 6 days.
You will be given analgesics and antibiotics for 5 to 10 days.
You will be given analgesics, antibiotics and a soothing gargle for 5-10 days.
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Next actions
As you have been administered general anesthesia, an adult must accompany you home. For the next 24 hours after surgery, a small amount of sedative may still be present in your body. Hence, you are advised not to carry out the following:
a. Drive a vehicle
b. Drink alcohol
c. Operate machinery
d. Take sedatives unless prescribed by the doctor
e. Sign any legal documents
Before leaving, you should have:
a. A medical certificate
b. A prescription written by your doctor and
c. A return appointment at the Ear, Nose and Throat Clinic for your post-operative visit.
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