What is FESS (Functional Endoscopic Sinus Surgery)?
Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive surgical procedure designed to restore normal drainage of the sinuses. The procedure uses a medical instrument called an endoscope, a thin, flexible tube with a camera that allows the surgeons to directly view the sinus passages and remove obstructions without external incision.
Endoscopic sinus surgery involves accessing the sinuses through the nostrils using specialised tools and a camera, allowing for precise treatment with minimal tissue disruption. Unlike traditional sinus surgery, which usually involves external incisions and a longer recovery time, FESS (sinus surgery) is performed internally and is often an outpatient procedure. Artemis Hospitals has a team of some of the best ENT surgeons who can perform complex endoscopic sinus surgery with a high success rate.
What are the Different Medical Conditions Treated with FESS Surgery?
Functional Endoscopic Sinus Surgery (FESS) is primarily recommended when conservative treatments such as antibiotics, nasal sprays, or decongestants fail to relieve persistent or recurring sinus issues. It is particularly effective in improving sinus drainage, reducing inflammation, and restoring normal breathing. Below are the common medical conditions for which FESS sinus surgery is indicated:
Chronic sinusitis is a prolonged inflammation of the sinus lining lasting more than 12 weeks, despite medical treatment. Symptoms often include nasal congestion, facial pain, pressure, and thick nasal discharge. FESS surgery helps open up the blocked sinus passages and promote better drainage, offering long-term relief from symptoms.
Nasal polyps are soft, painless, non-cancerous growths that form in the nasal passages or sinuses due to chronic inflammation. Large or multiple polyps can obstruct airflow and lead to frequent infections or loss of smell. Functional endoscopic sinus surgery (FESS) allows precise removal of polyps, restoring normal breathing and sinus function.
A deviated nasal septum occurs when the wall between the nostrils is displaced, narrowing one or both nasal passages. This can lead to difficulty breathing, nasal blockage, and recurrent sinus infections. While septoplasty corrects the septum, FESS may be combined with it to address any associated sinus blockage or inflammation.
Sinus Infections Not Responding to Medication
Some patients experience recurrent or chronic sinus infections that don’t respond well to antibiotics or medical therapy. In such cases, sinus endoscopic surgery helps by removing infected tissue, draining trapped mucus, and preventing further buildup, significantly reducing the frequency of infections.
Fungal Sinusitis or Recurrent Fungal Infections
Fungal sinusitis is more common in individuals with weakened immune systems or those exposed to certain environments. It can range from non-invasive forms to aggressive infections. FESS surgery is used to remove fungal debris and infected tissue while preserving the healthy lining of the sinuses.
What are the Different Types of FESS Surgery?
The type of FESS sinus surgery performed depends on which sinuses are blocked and the extent of the disease. Each type focuses on opening up specific sinus pathways to restore proper drainage and function.
This procedure focuses on the anterior (front) ethmoid sinuses, located between the eyes. It involves removing inflamed or infected tissue to improve airflow and drainage, especially in cases of chronic ethmoid sinusitis or nasal polyps.
Posterior ethmoidectomy targets the deeper ethmoid sinuses at the back of the nasal cavity. It is typically performed when infections or polyps are located in these less accessible areas and are not responding to medical treatment.
This type of FESS surgery opens and enlarges the natural opening of the maxillary sinus, which is located in the cheek area. It is often used to treat chronic maxillary sinusitis, facial pain, or infections related to dental issues.
Sphenoidotomy is performed to access and drain the sphenoid sinuses, which are deep within the skull behind the nasal cavity. This procedure is used for isolated sphenoid sinus infections or fungal sinusitis and requires a high level of precision due to the nearby critical structures like the optic nerve and brain.
When to Consult an ENT Specialist for Sinus Endoscopic Surgery?
You should consult an ENT specialist if you suffer from chronic sinusitis, frequent infections, or nasal obstructions that don’t respond to medication. At Artemis Hospital Gurgaon, our ENT specialists offer expert diagnosis and personalised treatment plans for FESS surgery.
Book an appointment with our expert ENT surgeons in Gurgaon.
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Who Should Consider Endoscopic Sinus Surgery?
Endoscopic sinus surgery is generally recommended when sinus-related symptoms significantly affect quality of life and do not respond to conventional treatments. If medications such as nasal sprays, antibiotics, or corticosteroids fail to provide lasting relief, FESS surgery may be the next step:
Adults and Children with Chronic Sinus Problems
Individuals, including children who suffer from chronic sinusitis, nasal congestion, frequent headaches, or postnasal drip that lasts for more than 12 weeks, may benefit from functional endoscopic sinus surgery.
Patients with Nasal Obstruction or Facial Pain
Patients experiencing difficulty breathing through the nose, facial pressure, or pain that doesn’t resolve with medication may have underlying structural issues or sinus blockages.
When Medical Therapy Fails to Offer Relief
If medications, including antibiotics, antihistamines, nasal corticosteroids, or saline rinses, do not adequately manage the symptoms, FESS sinus surgery may be considered to physically open blocked sinuses and restore natural drainage.
How to Prepare For FESS Procedure?
Proper preparation before undergoing Functional Endoscopic Sinus Surgery (FESS) helps ensure a smooth surgical experience and a faster recovery. The ENT specialist provides specific instructions based on the medical condition, some of which are below:
Medical Evaluation and Imaging
Before the surgery, the patient undergoes a detailed ENT evaluation, including nasal endoscopy and a CT scan. This helps map out the affected sinus areas and determine the appropriate FESS procedure steps.
Inform the doctor about all medications, supplements, and allergies. The patient may need to stop blood thinners (like aspirin or ibuprofen) several days before surgery to reduce bleeding risk.
FESS sinus surgery is typically performed under general anaesthesia or sedation, so the patient may feel dizzy after the surgery. It is recommended to have someone drive the patient home after the procedure.
The patient may be asked to fast (no food or drink) for at least 6–8 hours before surgery, especially if general anaesthesia is used.
Avoid smoking and alcohol in the days leading up to surgery, as these can interfere with healing and increase the risk of complications.
How is Functional Endoscopic Sinus Surgery Performed?
Functional Endoscopic Sinus Surgery (FESS) is performed using precision instruments and an endoscope inserted through the nostrils. This allows the surgeon to view and remove obstructions while preserving healthy tissue.
Unlike traditional surgery, FESS does not require any external incisions and the entire procedure is performed through the nostrils. This approach allows for the precise removal of obstructions while preserving as much healthy tissue as possible. Functional Endoscopic Sinus Surgery aims to restore natural sinus drainage, improve airflow, and reduce inflammation, all while minimising trauma and recovery time. Here's what happens during the FESS procedure:
Administration of Anaesthesia
The procedure begins with either general or local anesthesia to ensure the patient remains comfortable and pain-free throughout the surgery.
Insertion of Endoscope Through the Nostrils
A thin endoscope with a light and camera is inserted through the nasal passage to provide a clear, magnified view of the sinuses on a monitor.
Assessment and Identification of Blockages
The surgeon examines the sinus anatomy and identifies areas of obstruction, such as polyps, inflamed tissue, or narrowed drainage pathways.
Removal of Obstructive Tissue or Polyps
The surgeon uses specialised micro-instruments to remove polyps, thickened mucosa, or bony partitions that are blocking sinus drainage.
Enlarging the Natural Sinus Openings
The openings of the affected sinuses (ethmoid, maxillary, sphenoid, or frontal) are carefully widened to restore proper airflow and drainage.
Cleaning and Suctioning of Mucus or Pus
Accumulated mucus, pus, or infected material is suctioned out to reduce infection risk and clear the sinus cavities.
Preservation of Healthy Tissue
Only diseased or structurally abnormal tissue is removed, while healthy structures are preserved to maintain normal sinus function.
Nasal Packing or Dressing (If Needed)
In some cases, temporary nasal packing or absorbable dressings may be placed to control bleeding and support healing.
Post-Operative Instructions Given
Patients are given guidance on recovery, medications, nasal irrigation, and follow-up care before being discharged, usually on the same day.
What to Expect After FESS Surgery?
Post-surgery, patients can expect mild discomfort, congestion, and minor bleeding, which typically resolve within a week. While most patients experience noticeable relief from symptoms within weeks, it's important to understand the immediate effects, healing timeline, and follow-up process.
Mild Discomfort and Nasal Congestion
Patients may experience mild nasal pressure, congestion, or discomfort for a few days following the procedure. These symptoms are normal and are usually managed effectively with prescribed medications and nasal sprays.
Nasal Discharge and Light Bleeding
It is common to observe light bleeding or blood-tinged nasal discharge for the first few days post-surgery. This typically subsides without intervention. Patients are advised to avoid blowing their noses to prevent irritation.
Due to internal swelling, crusting, or packing material (if used), breathing through the nose may feel restricted for about a week. This gradually improves as healing progresses.
Regular Nasal Irrigation is Essential
Daily saline nasal irrigation is often prescribed to clear mucus, promote healing, and reduce the risk of infection. This is a key part of post-operative care after FESS sinus surgery.
Follow-Up Visits Are Important
Patients are required to attend scheduled follow-up visits, during which the ENT surgeon may perform gentle cleaning (debridement) to remove crusts or dried blood and assess healing progress.
Gradual Return to Normal Activities
Most patients can resume routine activities within 5–7 days after surgery. However, strenuous exercise, heavy lifting, and exposure to dust or smoke should be avoided for at least two weeks.
Sense of Smell May Temporarily Change
A temporary reduction or alteration in the sense of smell may occur, especially if nasal polyps were removed. This usually improves over time as the nasal passages heal.
Get advanced FESS (Functional Endoscopic Sinus Surgery) in Gurgaon for faster recovery, and expert ENT care.
Recovery After Functional Endoscopic Sinus Surgery (FESS)
Recovery after Functional Endoscopic Sinus Surgery (FESS) is generally smooth, especially when the patient follows medical advice and post-operative care instructions. While the procedure is minimally invasive, healing is a gradual process that typically occurs over several weeks. Here is the recovery timeline that can help patients manage symptoms effectively and avoid complications:
During the initial recovery period, patients may experience mild discomfort, nasal congestion, and light bleeding. Breathing through the nose may feel blocked due to internal swelling, crusting, or the presence of nasal packing (if used). Regular saline nasal irrigation is essential during this stage to keep the nasal passages clean and promote healing.
1 to 3 Weeks Post-Surgery
By the second week, most symptoms begin to improve. The nasal passages start to open up, and breathing becomes easier. Patients are advised to avoid strenuous activity, bending forward, and exposure to dust or smoke, as these can interfere with healing. Follow-up visits with the ENT specialist are crucial during this period for cleaning and monitoring progress.
3 to 6 Weeks Post-Surgery
At this stage, most patients notice a significant reduction in sinus symptoms such as facial pain, pressure, nasal congestion, and post-nasal drip. Any temporary changes in the sense of smell typically begin to improve. Continued use of saline sprays and adherence to prescribed medications support long-term recovery.
Long-Term Recovery and Care
Full internal healing may take up to 6–8 weeks, depending on the severity of the original condition and the type of FESS sinus surgery performed. Long-term management may include nasal sprays, allergy control, or routine ENT evaluations to prevent recurrence. Some patients may require ongoing care if they have underlying conditions such as nasal polyps or allergic rhinitis.
Artemis Hospitals Offers Advanced FESS Procedure by the Best ENT Surgeons in Gurgaon
Artemis Hospitals is nationally and internationally known for providing good, affordable and reliable treatment for different medical conditions associated with the ear, nose and throat. Our team of experienced ENT doctors are highly experienced in performing advanced endoscopic sinus surgery, tonsillectomy, adenoidectomy, eardrum repair procedure, and other medical procedures associated with ear, nose and throat.
The department of ENT at Artemis is an all-inclusive, comprehensive unit with a list of diagnostic and therapeutic options under the same roof. A set of detailed tests and evaluations undertaken by a team of proficient ENT Surgeons and Audiologists determines the further course of action.
Artemis Hospitals aim to provide excellent state-of-the-art patient care in a supportive environment and conduct educational programs that provide excellent training in research and clinical care.
Our Services
Reviewed By Dr. Poonam Gautam
Sr. Consultant - ENT & ENT Surgery
Artemis Hospitals
Frequently Asked Questions
What is functional endoscopic sinus surgery?
Functional endoscopic sinus surgery (FESS) is a minimally invasive procedure used to treat chronic sinus problems by removing obstructions and improving drainage pathways through the nose.
What is the functional endoscopic sinus surgery cost in India?
The cost of functional endoscopic sinus surgery in India varies by hospital and region. It generally depends on factors such as the severity of the condition, the type of surgery, the technique used, the consultation charge of the surgeon, hospital stay (if any), etc. Get in touch with us to get an estimate for the FESS surgery cost.
What conditions are treated with functional endoscopic sinus surgery?
FESS surgery is used to treat chronic sinusitis, nasal polyps, deviated septum, fungal infections, and sinus infections that do not respond to medication.
How long does it take to recover from functional endoscopic sinus surgery?
Most patients recover within 1 to 2 weeks, although complete healing may take up to 4–6 weeks depending on the case.
Is bleeding common after FESS surgery?
Yes, minor nasal bleeding is common during the first few days after surgery and typically resolves on its own. Significant bleeding is rare but should be reported to the ENT specialist if it occurs.
Can FESS surgery cause infections?
While endoscopic sinus surgery is performed under sterile conditions, there is a small risk of post-operative infection. This is usually managed with antibiotics and proper nasal care.
Will there be a loss of smell after FESS?
Some patients may experience a temporary reduction or loss of smell after surgery, especially if nasal polyps are removed. In most cases, the sense of smell returns within a few days to weeks.
Is revision surgery ever needed after FESS?
Yes, revision FESS surgery may be required in some cases, especially if nasal polyps regrow, scarring develops, or symptoms recur. Regular follow-ups help detect and manage these issues early.
What are the long-term complications of functional endoscopic sinus surgery?
Long-term complications are uncommon but may include persistent nasal dryness, crusting, or scar tissue formation. These are usually managed with medical therapy and follow-up care.
What is the success rate of FESS surgery?
FESS surgery has a success rate of over 90% in relieving symptoms and reducing sinus infections when performed by experienced ENT surgeons.
What are the FESS surgery side effects or risks?
Common side effects include mild bleeding, congestion, or temporary loss of smell. Serious complications like injury to nearby structures are rare.
What are the indications for FESS surgery?
FESS is indicated for patients with chronic sinusitis, nasal blockages, polyps, and recurrent infections that do not improve with medication.
Is FESS surgery painful?
FESS surgery is generally not painful due to anaesthesia. Mild discomfort may occur after the procedure, which is manageable with medications.
How long does sinus endoscopic surgery take?
Sinus endoscopic surgery typically takes between 30 to 90 minutes, depending on the complexity of the case.
What precautions should I take after FESS surgery?
Avoid blowing your nose, strenuous activity, and dusty environments. Follow your ENT’s medication and follow-up schedule strictly.
What foods should I avoid after sinus endoscopic surgery?
Avoid hot, spicy foods and beverages that may cause irritation or bleeding. Stick to soft and cool foods initially.
Where can I get FESS surgery near me?
You can get FESS surgery at Artemis Hospital, one of the leading healthcare centres offering advanced ENT care in Gurgaon. To schedule an appointment, give a call or book an appointment through our website.
Who is the best ENT specialist for endoscopic sinus surgery near me in Gurgaon?
Artemis Hospital Gurgaon has some of the best ENT specialists skilled in FESS surgery and modern sinus treatments.
Is Artemis Hospital in Gurgaon good for FESS surgery?
Yes, Artemis Hospital in Gurgaon is well-equipped with advanced technology and experienced ENT surgeons, making it an excellent choice for FESS surgery.
How do I book an appointment for FESS sinus surgery at Artemis Hospital?
You can book an appointment by visiting the Artemis Hospital website or calling their ENT department directly to schedule your consultation.
