Functional Endoscopic Sinus Surgery (FESS)​ - Types, Benefits & Procedure

FESS encompasses a range of endoscopic procedures designed to restore normal drainage and airflow of the paranasal sinuses. The extent of surgery depends on the underlying disease, the sinuses involved, and the patient's anatomical considerations. Below are some common FESS surgery types: 

• Uncinectomy 
• Maxillary antrostomy 
• Anterior ethmoidectomy 
• Posterior ethmoidectomy 
• Total ethmoidectomy 
• Sphenoidotomy 
• Frontal sinusotomy 
• Polypectomy with FESS 
• Complete FESS / Pansinus surgery 
• Revision FESS
  
  

Uncinectomy

This is a basic step in FESS surgery. In this procedure, the surgeon removes a thin, curved bone and tissue structure called the uncinate process, which lies near the natural drainage pathway of the maxillary sinus. Removing this structure helps the surgeon see the sinus opening clearly and improves access for further sinus treatment.

Maxillary antrostomy

Maxillary antrostomy is an FESS procedure in which the natural opening of the maxillary sinus, which is located in the cheek area, is widened. This helps blocked mucus drain more easily and improves ventilation of the sinus. It is commonly done for chronic maxillary sinusitis, recurrent sinus infections, fungal sinus disease, or blockage of the maxillary sinus.

Anterior ethmoidectomy

This is a minimally invasive surgical procedure used to clear blockages and infected tissue from the anterior ethmoid sinuses, which are located between the eyes and the bridge of the nose. This procedure helps clear infection, swelling, or polyps from the anterior ethmoid region and improves drainage between the nose and nearby sinuses.

Posterior ethmoidectomy

This procedure is a deeper FESS procedure, done to remove diseased air cells from the back part of the ethmoid sinuses, which are located between the eyes. It is usually done when chronic sinus disease, nasal polyps, or inflammation extends into the posterior ethmoid area. This procedure can be helpful for improving airflow, drainage, and access to deeper sinus regions when needed.

Total ethmoidectomy

Total ethmoidectomy is a type of FESS in which diseased ethmoid air cells are removed from both the front and back parts of the ethmoid sinuses, located between the eyes. This helps clear long-standing infection, swelling, or blockage and improves drainage from nearby sinuses.

Sphenoidotomy 

Sphenoidotomy is a FESS procedure used to open the sphenoid sinus, which lies deep behind the nose. It may be done for chronic sphenoid sinusitis, fungal sinus infection, mucoceles, or blockage in this deep sinus area, helping mucus drain more freely.

Frontal Sinusotomy

This procedure opens the drainage pathway of the frontal sinuses, which are located behind the forehead. It helps relieve blockage, remove diseased tissue and improve mucus drainage. This procedure is commonly considered in patients with chronic frontal sinusitis or recurrent frontal sinus infections.

Polypectomy with FESS (FESS Polypectomy)

Polypectomy with FESS involves removing nasal polyps along with opening blocked sinus drainage pathways. It is commonly done for chronic rhinosinusitis with nasal polyps, where soft, non-cancerous swellings inside the nose and sinuses cause nasal blockage, reduced smell, discharge, and breathing difficulty.

Complete FESS / Pansinus surgery

Complete FESS, also called pansinus surgery, is done when the disease affects several or all sinus groups. During this procedure, the surgeon may open the maxillary, ethmoid, sphenoid, and frontal sinuses to improve overall sinus drainage, reduce blockage, and manage widespread chronic sinus disease.

Revision FESS

The revision FESS procedure is performed when a prior sinus surgery fails to relieve chronic sinusitis or polyps. It may be needed due to scar tissue, persistent inflammation, recurrent polyps, incomplete drainage, or disease that has come back over time.

FESS indications

FESS is mainly recommended for people with sinonasal diseases that do not respond effectively to suitable medical treatment or when anatomical blockage contributes to prolonged disease. The surgery restores normal sinus drainage and ventilation, improves mucociliary clearance, and relieves symptoms while preserving healthy mucosa. The common FESS surgery indications include the following: 

• Chronic rhinosinusitis (CRS)
• Recurrent acute sinusitis
• Nasal polyps
• Sinus mucoceles and cysts
  
  

Procedures that may accompany FESS

• Deviated nasal septum with sinus obstruction

Other endoscopic endonasal procedures

• Cerebrospinal fluid (CSF) leak closure
• Orbital decompression
• Dacryocystorhinostomy (DCR) 
• Choanal atresia
• Severe recurrent nosebleeds (epistaxis)
• Benign or malignant sinonasal tumours
  
  

Chronic rhinosinusitis (CRS)

FESS may be advised when long-term sinus inflammation causes persistent nasal blockage, thick nasal discharge, facial pressure, reduced smell, or repeated symptoms despite appropriate medical treatment. FESS helps to open up blocked sinus drainage pathways and improve sinus ventilation. 

Recurrent acute sinusitis

In recurrent acute sinusitis, repeated infections may occur because the natural sinus openings are narrowed or obstructed. Endoscopic sinus surgery helps by opening these drainage pathways, improving ventilation, and allowing mucus to drain more freely. This may reduce the frequency of sinus infections when medications alone are not enough and imaging studies show sinus blockage.

Nasal polyps

Nasal polyps are non-cancerous swellings that can block the nose and sinus openings. The surgeon carefully removes the polyps and opens the affected sinuses. This aids in improving nasal breathing, smell, mucus drainage, and access for nasal steroid sprays after surgery, which may reduce the risk of recurrence. 

Sinus mucoceles and cysts

A sinus mucocele is a benign, mucus-filled cyst that develops when a paranasal sinus drainage pathway becomes blocked. It slowly expand and press on nearby structures ( such as eyes). FESS sinus surgery treats mucoceles by opening the blocked sinus and draining the mucus-filled cavity, a process often called endoscopic marsupialisation. This helps relieve pressure and allows the sinus to drain normally again.

 

Deviated nasal septum with sinus obstruction

A deviated nasal septum (DNS) can narrow the nasal passage and contribute to poor sinus drainage. In these cases, FESS can be combined with septoplasty when septal deviation blocks access to the sinuses or contributes to sinus obstruction. FESS opens up the affected sinus pathways, and the septoplasty procedure straightens the nasal septum to improve airflow and surgical access.

Cerebrospinal fluid (CSF) leak closure

A CSF leak occurs when fluid surrounding the brain escapes through a small defect in the skull base into the nose. Endoscopic sinus surgery techniques allow the ENT surgeon to reach the leak site through the nostrils without an external cut. The defect is then sealed using tissue grafts or surgical repair materials to stop the leak and reduce the risk of infection such as meningitis. Skull base defects and CSF rhinorrhea are recognized indications for endoscopic sinus surgery.

Orbital decompression

This is an endoscopic procedure performed through the nose to create more space around the eye socket. During surgery, the ENT surgeon removes part of the thin bony wall between the sinuses and the orbit, usually near the ethmoid sinus, so the swollen orbital tissues can move into the sinus space. This helps reduce the pressure behind the eye and may improve eye bulging, eye discomfort, or pressure-related symptoms, especially in conditions such as thyroid eye disease. 

Dacryocystorhinostomy (DCR) 

Endoscopic Dacryocystorhinostomy, or DCR, treats blockage of the tear drainage system. In the endoscopic DCR procedure, the surgeon creates a new opening between the tear sac and the nasal cavity through the nose. This allows tears to bypass the blocked nasolacrimal duct and drain directly into the nose, helping reduce constant watering of the eye, recurrent tear sac infection, and swelling near the inner corner of the eye. 

Choanal atresia

Choanal atresia is a congenital condition where a baby is born with a blockage—made of bone, soft tissue, or both—at the back of the nasal passage. Endoscopic surgery can be used to create or reopen this blocked passage through the nose. In selected cases, FESS-type endoscopic techniques help restore nasal airflow and improve breathing, especially when the blockage affects normal nasal drainage or breathing.

Severe recurrent nosebleeds (epistaxis)

In severe or repeated nosebleeds that don't respond to medicines, packing, or cautery. In these conditions, an endoscopic sinus surgery is performed, that help identify the bleeding point deep inside the nose. The surgeon can cauterize the bleeding vessel or ligate a feeding artery, such as the sphenopalatine artery, through the nasal route. This helps control difficult nosebleeds while avoiding larger external cuts in many cases. 

Benign or malignant sinonasal tumours

For selected benign or malignant tumours of the nose and sinuses, endoscopic sinus surgery can help with biopsy, tumour removal, or clearance of blocked sinus areas. The endoscope gives a magnified view of narrow nasal and sinus spaces, allowing the surgeon to remove suitable tumours through the nose with less external scarring. In cancer cases, treatment may also require radiotherapy, chemotherapy, or combined surgery depending on tumour type, stage, and spread.

FESS contraindications

FESS is a very safe and effective surgical procedure, but there are certain conditions that can increase the risk of complications or may require other surgical approaches. These conditions are considered contraindications to FESS: 

Absolute contraindications:

• Severe uncontrolled bleeding disorders 
• Not fit for general anaesthesia
• Acute uncontrolled infection 
• No clear sinus disease on endoscopy/CT scan 

Relative contraindications:

• Ongoing cold, flu, or acute sinus infection
• Severe septal deviation or nasal obstruction
• Previous extensive nasal or sinus surgery 
• High-risk anatomical variations 
• Elective FESS during pregnancy
  
  

Absolute contraindications

FESS surgery procedure is generally avoided in patients with conditions that make surgery unsafe or impossible, such as:

Severe uncontrolled bleeding disorders 

Patients who have bleeding disorders or those on blood-thinning medications may bleed excessively during the time of surgery. Since FESS involves operating in delicate sinus areas near the eyes and brain, uncontrolled bleeding can be dangerous, which makes the procedure unsafe.

Not fit for general anaesthesia

FESS surgery is performed under general or sometimes local anesthesia. If a patient has severe heart, lung, or other systemic conditions that make anesthesia risky may not tolerate the procedure safely. Surgery is generally avoided until the patient is medically stable.

Acute uncontrolled infection 

Performing FESS surgery when there is already an active severe sinus or systemic infection can worsen the infection and increase the risk of complications such as spreading infection to the eyes or brain. Surgery is usually postponed until the infection is completely controlled with medication.

No clear sinus disease on endoscopy/CT scan 

FESS is only intended to treat clearly defined sinus disease, such as chronic sinus blockage or polyps. If imaging or endoscopy does not show any kind of significant disease, surgery may be unnecessary and could expose the patient to avoidable risks.

Relative contraindications

These are situations where FESS may be possible but require careful evaluation and planning:

Ongoing cold, flu, or acute sinus infection

Generally, performing FESS surgery during an active upper respiratory infection can increase the risk of complications, these can be excessive bleeding, swelling, and poor healing. The inflamed tissues are more fragile, making surgery technically difficult and recovery slower. Surgery is postponed until the infection is resolved.

Severe septal deviation or nasal obstruction

In the case of a deviated septum or narrow nasal passages, it makes it hard for the surgeon to safely navigate the FESS instruments. This increases the risk of accidental injury to nearby structures. In such cases, surgery may be combined with a septoplasty to improve access and safety.

Previous extensive nasal or sinus surgery 

Previous procedures can result in scar tissue or change normal anatomy, making endoscopic navigation difficult. Scar tissue may hide landmarks, increase bleeding risk, and complicate disease clearance. Surgeons carefully plan the surgery using imaging to avoid complications.

High-risk anatomical variations 

Some patients may have unusual sinus or skull structure; these variations increase the risk of serious complications during the surgery, including injury to the eye or brain. Careful pre-operative imaging and expert surgical planning are important.

Elective FESS during pregnancy 

Sinus surgery is commonly avoided during the time of pregnancy unless it is absolutely necessary. Risks may include anesthesia effects on the fetus, maternal stress, and potential complications from bleeding or infection. Surgery is postponed until after delivery unless it is urgent.

Minimally invasive sinus surgery, or FESS, is designed to restore the normal drainage and ventilation of the paranasal sinuses. FESS improves sinus function, reduces symptoms, and improves the patient's quality of life by removing the underlying anatomical blockage. The following are key benefits of FESS surgery: 

• Improves sinus drainage and ventilation
• Relieves nasal blockage and congestion
• Reduces recurrent sinus infections
• Decreases facial pain and pressure
• Enhances sense of smell
• Preserves normal sinus mucosa
• No external scars
• Faster recovery with less discomfort
• Improves quality of life
  
  

Improves sinus drainage and ventilation

FESS helps to open the blocked sinus passages, allowing mucus to drain. Proper drainage prevents the accumulation of secretions and reduces the chances of future infection.

Relieves nasal blockage and congestion

The surgery helps by removing the diseased tissue or polyps and widening the sinus openings. FESS clears the nasal passages, hence making breathing easier and reducing the feeling of nasal stuffiness.

Reduces recurrent sinus infections

Poor drainage promotes bacterial growth and repeated infections. FESS improves sinus drainage, reducing mucus stagnation and ultimately lowering the frequency of sinus infections.

Decreases facial pain and pressure

Chronic sinus blockage can cause problems like facial pressure, headaches, or pain around the eyes and forehead. FESS helps to alleviate these problems by restoring normal sinus airflow and drainage.

Enhances sense of smell

Blocked or inflamed sinuses can impair the sense of smell. By clearing obstructions and inflammation, FESS improves olfactory function.

Preserves normal sinus mucosa

Unlike more extensive traditional procedures, FESS is designed to remove only diseased tissue while preserving healthy nearby mucosa, which helps maintain normal sinus physiology.

No external scars

Since FESS is performed entirely through the nostrils using an endoscope, it does not require external facial incisions and results in no visible scars.

Faster recovery with less discomfort

As the functional endoscopic sinus surgery procedure is minimally invasive in nature, the results include shorter surgery time, less bleeding, and quicker healing, allowing patients to resume normal activities sooner.

Improves quality of life

FESS surgery helps to reduce symptoms such as nasal obstruction, recurrent infections, facial pain, and impaired smell, which improves daily functioning, sleep quality, and overall well-being of a person.

The steps of FESS surgery include the following:

Before FESS procedure

• ENT evaluation: The doctor reviews symptoms, previous treatments, allergies, medications, and history of sinus infections or previous nasal surgery. A detailed examination of the nose and sinuses is performed.
• Nasal endoscopy: A nasal endoscopy may be performed to examine the nasal passages and sinus openings directly. It helps the surgeon identify inflammation, polyps, infection, blockage, or other abnormalities.
• CT scan of the sinuses: A CT scan is usually performed before FESS to assess the anatomy of the sinuses, identify areas of blockage or disease, and help the surgeon plan the procedure.
• Medication review: Patients should inform the doctor about all prescription medicines, over-the-counter medicines, vitamins, and supplements. Medicines that can increase bleeding risk may need to be adjusted before surgery, but patients should not stop any medication without medical advice.
• Assessment of overall health: The surgical and anaesthesia teams assess conditions such as high blood pressure, diabetes, heart or lung disease, allergies, and previous reactions to anaesthesia. Blood tests or other investigations may be advised when appropriate.
• Management of infection or inflammation: If there is an active infection or significant inflammation, the ENT specialist may prescribe medicines such as antibiotics, nasal corticosteroids, or other treatment before surgery when clinically appropriate.
• Discussion of the procedure: The surgeon explains the procedure, expected benefits, possible risks, alternatives, anaesthesia, post-operative care, and expected recovery. The patient can discuss any concerns before providing informed consent.
• Fasting before surgery: If general anaesthesia is planned, the patient will receive specific instructions about when to stop eating and drinking before the procedure. These instructions should be followed carefully.
• Avoiding smoking: Patients may be advised to stop smoking before surgery because smoking can interfere with healing and increase the risk of postoperative complications.
• Final preoperative preparation: On the day of surgery, the surgical team confirms the patient's identity, procedure, medical history, allergies, medications, and planned surgical site before taking the patient to the operating room.
  
  

During FESS procedure

• Anaesthesia is given: FESS is usually performed under general anaesthesia, so the patient remains asleep and comfortable throughout the procedure.
• Nasal passage is prepared: The surgeon places a nasal decongestant and local anaesthetic medication inside the nose to reduce swelling and bleeding and improve visibility.
• Endoscope insertion: A thin, rigid endoscope with a small camera is gently inserted through the nostril. This allows the surgeon to clearly view the nasal cavity and openings of the affected sinuses without making an external incision.
• Blocked areas identification: The surgeon examines the nasal passages and identifies areas of inflammation, polyps, mucus, scar tissue, or other blockage affecting normal sinus drainage.
• Sinus openings widened: Using specialised instruments, the surgeon carefully removes or opens the tissues blocking the natural drainage pathways of the affected sinuses.
• Diseased tissue removal: These may include polyps, infected tissue, thickened mucosa, or other obstructing tissue, which may be removed when necessary. The blockage is cleared while preserving healthy sinus lining as much as possible.
• Affected sinuses are treated: Depending on the disease, the surgeon may perform procedures such as uncinectomy, ethmoidectomy, maxillary antrostomy, sphenoidotomy, or frontal sinusotomy to improve drainage from the involved sinuses.
• Bleeding is controlled: The surgeon carefully controls bleeding throughout the procedure. In some cases, the surgeon may place absorbable materials inside the nose to support healing and control minor bleeding.
• Final inspection: The surgeon checks the treated areas using the endoscope to ensure that the sinus drainage pathways are adequately opened and that there is no significant bleeding.
• Recovery from anaesthesia: After the procedure is completed, the patient is taken to the recovery area and monitored while the effects of anaesthesia wear off.
  
  

After FESS Procedure

• Recovery-room monitoring: After surgery, the patient is monitored as the effects of anaesthesia wear off. Vital signs, breathing, nasal bleeding, and overall condition are checked before discharge or admission.
• Pain and discomfort management: Mild facial pressure, nasal congestion, headache, or discomfort may occur after FESS. Pain-relieving medicines prescribed by the doctor can help manage these symptoms.
• Nasal care: The ENT specialist may recommend saline nasal sprays or saline irrigation to keep the nasal passages moist and remove blood, mucus, and crusts. These should be used exactly as instructed.
• Nasal bleeding management: Small amounts of nasal discharge stained with blood may appear in the first few days, and the patient must adhere to the surgeon's instructions by avoiding vigorous blowing of the nose during the early stages of recovery.
• Medications: The doctor may prescribe nasal corticosteroids, antibiotics if needed, or other medications to reduce inflammation and support healing, depending on the patient's situation.
• Rest and activity: It is advised to get adequate rest during the first phase of recovery. Generally, light activities can be performed gradually, but strenuous exercise, heavy lifting, and activities which increase pressure in the nose should be avoided for a while.
• Avoid nose blowing and straining: Forceful nose blowing, heavy straining, or bending with the head down may increase nasal pressure and bleeding. The surgeon will advise when these activities can be resumed.
• Follow-up and nasal cleaning: Follow-up appointments are important after FESS. The ENT specialist may perform nasal endoscopy and postoperative cleaning when required to remove crusts or accumulated material and assess healing.
  

Functional endoscopic sinus surgery is generally considered safe, but like any surgery, it can have potential complications. Most are minor and temporary, while serious complications are rare. These FESS surgery complications may include:

• Nasal bleeding
• Infection
• Nasal congestion and crusting
• Persistent or recurrent sinus symptoms
• Reduced or altered sense of smell
• Scar tissue formation
• Eye-related complications
• Tear-duct injury
• Brain or skull-base injury
• Need for revision surgery
• Anaesthesia-related complications
  
  

Nasal bleeding

FESS involves working on the lining and blood vessels inside the nose and sinuses. Mild bleeding or blood-stained discharge is common during the early recovery period. Rarely, a blood vessel may bleed more heavily and require treatment to control the bleeding.

Infection

Infection can develop in the nose or sinuses after surgery, although it is generally uncommon. Appropriate postoperative care and medicines when indicated can help manage this complication.

Nasal congestion and crusting

Swelling, mucus, and crust formation inside the nose can temporarily cause nasal blockage and difficulty breathing. These symptoms usually improve as the nasal tissues heal.

Persistent or recurrent sinus symptoms

Some patients may continue to experience nasal blockage, facial pressure, discharge, or other sinus symptoms after surgery. Symptoms can also recur if the underlying sinus disease persists or returns.

Reduced or altered sense of smell

Swelling, crusting, inflammation, or changes in the sinus lining can temporarily affect the sense of smell. In some patients, reduced or altered smell may persist.

Scar tissue formation

Scar tissue, also called adhesions or synechiae, can develop between healing surfaces inside the nose. Significant adhesions may narrow the nasal passages or sinus openings and sometimes require additional treatment.

Eye-related complications

Because the sinuses are close to the eye socket, unusual problems such as orbital bleeding or damage, swelling around the eye, diplopia (double vision), limited eye movement, or visual abnormalities may occur. Serious orbital complications are uncommon but can potentially threaten vision.

Tear-duct injury

The tear-drainage system is located close to some of the sinus structures. Rarely, it can be injured during surgery, which may cause epiphora (excessive watering of the eye).

Brain or skull-base injury

The skull base lies immediately above some of the paranasal sinuses. Rarely, surgical injury can cause a cerebrospinal fluid (CSF) leak or, in very unusual cases, other intracranial complications.

Need for revision surgery

Some patients may require another sinus procedure if symptoms persist or recur, significant scar tissue develops, or the sinus drainage pathways become blocked again.

Anaesthesia-related complications

When FESS is performed under general anaesthesia, there is a potential risk of complications such as nausea, breathing problems, allergic reactions, or cardiovascular complications. The individual risk depends on the patient's health and medical history.

FESS surgery recovery occurs gradually. The exact time varies depending on the extent of the surgery and the underlying sinus condition. Patients return to their normal daily activities within about 1–2 weeks, while complete healing of the sinus lining can take several weeks to a few months.

• First few days: Nasal blockage, mild pain or pressure, swelling, blood-stained discharge and crusting are common. Saline nasal irrigation is generally recommended during this period.
• 1–2 weeks: Nasal congestion and discharge usually begin to improve. The nose and sinus cavities continue to heal, and many patients can gradually return to their usual daily activities. Return to normal activities at around 9–10 days after endoscopic sinus surgery.
• 3–6 weeks: The nasal lining continues to recover. Some patients may still have crusting, swelling or fluctuating symptoms during this stage. Follow-up examinations help monitor healing and manage any crusting or adhesions when necessary.
• 6–12 weeks: The sinus lining continues to mature and recover. Mucosal healing occurs during this period, although the exact duration differs between patients.
• After 3 months: Most of the healing is generally well established, although patients with chronic sinusitis or nasal polyps may continue to need medical treatment and follow-up to maintain the benefits of surgery.
  

What questions can patients ask the healthcare team about FESS surgery?

• Why do I need FESS, and what problem is the surgery intended to treat?
• Are there any non-surgical treatment options I should try first?
• What will happen during the FESS procedure? 
• What are the possible risks and complications of FESS?
• How much pain, swelling, bleeding, or nasal blockage should I expect after surgery?
• What medicines and nasal rinses will I need after surgery?
• Will I need nasal cleaning or endoscopic examinations during recovery?
• When can I expect my sinus symptoms and sense of smell to improve?
• Can sinus problems or nasal polyps come back after FESS?
• What symptoms after surgery should prompt me to contact the doctor immediately?

Difference between functional endoscopic sinus surgery and balloon sinuplasty

What conditions can FESS treat?

FESS is used for chronic or recurrent sinusitis that has not improved with medical treatment. It may also be used for conditions such as nasal polyps and selected other disorders affecting the nose and sinuses. In certain situations, similar endoscopic techniques may be used for problems such as blocked tear ducts or selected nasal tumors.

Which sinuses can be treated with FESS?

FESS can be used to treat disease affecting one or more of the paranasal sinuses, including the maxillary, ethmoid, frontal, and sphenoid sinuses. The specific sinus treated depends on where the blockage, inflammation, polyps, or other disease is present. The surgeon uses a nasal endoscope to open the affected sinus drainage pathways while preserving healthy tissue as much as possible.

Why is a CT scan needed before the FESS procedure?

A CT scan of the sinuses provides detailed images of the sinus structure and helps the surgeon identify blocked or diseased sinuses. It also shows important structures around the sinuses, including the eye socket and skull base, which helps the surgeon plan the procedure safely. A CT scan is important before planning for surgery.

How long does nasal congestion last after FESS?

Nasal congestion is common after FESS because of swelling, mucus, and crusting inside the nose. It usually improves gradually over the first few weeks as the tissues heal. Some patients may experience congestion for several weeks, particularly after more extensive surgery. Regular saline irrigation and the postoperative treatment recommended by the ENT specialist can help with recovery.

How often should saline nasal irrigation be used after FESS?

The frequency of saline nasal irrigation depends on the extent of surgery and the surgeon's postoperative instructions. Many patients are advised to perform saline irrigation several times a day during the early recovery period, but this is individualized by the ENT specialist. Using the recommended saline solution correctly can help remove mucus and crusts, keep the nasal passages moist, and support healing.

What is nasal debridement after FESS?

Nasal debridement is a procedure in which the ENT specialist gently removes blood clots, crusts, mucus, and healing tissue from inside the nose after FESS. It is usually done during follow-up visits using a nasal endoscope and helps the surgeon check healing and keep the sinus openings clear.

Is revision FESS surgery sometimes needed?

Yes, many patients tolerate their first FESS procedure well; revision surgery may sometimes be needed if sinus symptoms continue or return, the sinus openings become blocked again, significant scar tissue develops, or the underlying sinus disease remains difficult to control. The decision depends on the patient's symptoms, endoscopic findings, imaging, and response to medical treatment.

Can FESS and septoplasty be done together?

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