Endoscopic Sinus Surgery (ESS) or Functional Endoscopic Sinus Surgery (FESS) is a surgical procedure done in the operating room with general anesthesia. The goal of this surgery is to remove thickened bones, polyps, scar tissue and swollen nasal lining that is blocking the snus passages from draining properly. In the past relatively a relatively aggressive approach was used. Currently a “less is more” approach is used with an emphasis on removing only diseased or problematic structures and maintaining as much of the normal tissues as possible
Indications: Sinus Surgery is indicated for patients that have tried medical management (antibiotics, nasal sprays, allergy treatment, saline rinses) but are still having sinusitis symptoms or infections. A CT Scan is always done to determine if the patient’s sinus anatomy will indeed benefit from the dilation procedure. Patients with moderate to severe sinus disease will do best with this treatment.
Preparation: Patients are given full instructions to follow for 1 to 2 weeks prior to their procedure. A medical clearance from your primary care Physician and certain blood work may also be needed. In addition, patients also continue any medical management that has been used for their sinus problems previously. Certain medications like aspirin and other blood thinners will need to be stopped in advance of the procedure. The Surgery Center or Hospital where the surgery will be done are also directly involved in preparing patients for their Sinus Surgery. Antibiotics and oral steroids may be started before the surgery to help decrease inflammation for the surgery and to help with the healing afterwards.
What to expect during the procedure: Sinus Surgeries (ESS,FESS) are performed under general anesthesia in a fully certified Surgery Center or Hospital setting. Since the procedure is done under general anesthesia, patients having Sinus Surgery do not experience anything during the procedure except for a feeling of drifting off to sleep as the anesthesia starts to work. Many patients wake up feeling as though they just had an excellent night’s sleep.
Recovery and Follow Up: Patients are provided with complete recovery instructions prior to their surgery so they may prepare for optimal healing. Some patients may have some initial symptoms from general anesthesia (nausea, vomiting, feeling cold, sore throat) which are carefully monitored and treated by the Anesthesiology and Nursing teams prior to a patient being sent home. Majority of patients will have a mild to moderate nosebleed for up to 3 days after the surgery (Dr Jafri does not use nasal packing after surgery in the majority of his cases – there has been no proven clinical benefit to nasal packing and the pain and discomfort following surgery is greatly increased when packing is used). Patients can use Tylenol as needed for any pain and discomfort. Most patients do not even need any additional pain medication. Saline rinses are started after the surgery to help keep the nose clean and help promote healing. Headaches can occur after sinus surgery and these are typically temporary. Dr Jafri follows up directly with his patients the day of and after surgery to check on their progress. In addition, patients are given direct contact information for Dr Jafri to help address any questions or concerns they have during the recovery period. Follow up is also done in the office within 1 week after the surgery to examine the patient and help clean the nose as crusting is very common after sinus surgery.
Costs: Sinus Surgery is covered by insurance. Our office will check your insurance coverage and advise of any potential costs based on your specific plan prior to scheduling any procedure. We can also provide you with the relevant CPT codes so you can speak with your insurance provider as well.
Risks: All procedures have inherent risks, benefits, alternatives and complications associated with them and to the specific individual patient being treated. Dr Jafri will review these with you in detail and answer any questions you have before you proceed with any procedure and as part of the process of whether to proceed or not.