FESS (Functional Endoscopic Sinus Surgery)

Your nose has been blocked since last winter. Thick mucus drips down the back of your throat, your face feels heavy when you bend forward, and food doesn't taste of much any more. You've finished course after course of antibiotics and sprays, and the relief lasts only as long as the medicine does.

The sinuses are air spaces in the bones around the nose and eyes. They drain into the nose through narrow channels. When those channels stay swollen, or are blocked by polyps (soft, grape-like swellings of the lining), mucus pools and the lining stays inflamed. In functional endoscopic sinus surgery (FESS), the surgeon passes a thin telescope called an endoscope through the nostrils and, watching on a video screen, removes the blockages and widens the natural drainage openings. Healthy lining is left in place so the sinuses can clear themselves again, which is where the word "functional" comes from.

Most people breathe more easily and have fewer infections afterwards, and many with polyps find their sense of smell improving. Surgery doesn't switch off the underlying tendency to inflammation, though. People with polyps, asthma or allergy usually need a steroid spray or rinse long term, and polyps can return in some.

Chronic sinusitis and nasal polyps are among the conditions our ENT department treats most often, with medicines first and FESS when medical treatment has had a fair trial. We assess you with video endoscopy of the nose and a CT scan of the sinuses before deciding.

FESS is for sinus disease that persists despite proper medical treatment, usually several weeks of saline rinses, steroid sprays and, where appropriate, antibiotics or steroid tablets. A CT scan confirms which sinuses are blocked and maps the anatomy before surgery.

Recovering from sinus surgery is mostly about keeping the nose clean while it heals. The first two weeks feel like a heavy cold.