Functional endoscopic sinus surgery (FESS) is the primary safe approach used currently for the surgical treatment of chronic sinusitis.
This procedure is a minimally invasive, safe and it can be performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort. It can be combined with other nasal operations (septoplasty, turbinate radiofrequency etc.).
A recently developed alternative to functional endoscopic sinus surgery is balloon sinuplasty. This technique uses balloon catheters to dilate the maxillary, frontal, and sphenoid natural ostia without bone or soft-tissue removal. Reports show persistent patient symptom improvement and sinus ostia patency.
The most common indication for endoscopic sinus surgery is “chronic rhinosinusitis”.
The most common indications for endoscopic sinus surgery are as follows:
• Chronic sinusitis refractory to medical treatment
• Recurrent sinusitis
• Nasal polyposis
• Antrochoanal polyps
• Sinus mucoceles
• Excision of selected tumors
• Cerebrospinal fluid (CSF) leak closure
• Orbital decompression (eg, Graves ophthalmopathy)
• Optic nerve decompression
• Dacryocystorhinostomy (DCR)
• Choanal atresia repair
• Foreign body removal
• Epistaxis control
There are probably no absolute contraindications to endoscopic sinus surgery.
The most common relative contraindications for endoscopic sinus surgery are as follows:
• Absence of specific osteomeatal complex abnormalities.
• Oesteomyelitis involving the sinuses.
• Frontal sinus disease with stenosed internal ostium.
• Threatened intracranial and / or intracerebral complications.
• Inaccessible lateral frontal sinus disease.
Smoking is also consider as a relative contraindication to endoscopic sinus surgery.
Technique of Endoscopic Sinus Surgery
Endoscopes with different diamet