Endoscopic sinus surgery
Day-case keyhole surgery to open blocked sinuses and remove polyps.
Endoscopic sinus surgery (ESS, also called FESS) treats sinus and nose problems such as chronic rhinosinusitis with nasal polyps when medical treatment is no longer controlling symptoms. It removes polyps and opens the sinuses more widely into the nose, so that long-term nasal medication can reach the lining and treat the inflammation that drives the symptoms.
It is not a cure. Long-term nasal medication is still needed afterwards to slow the return of symptoms and polyps, and some people need more than one operation over their lifetime, particularly if regular medication lapses.
Where the disease is confined to the frontal sinus and the rest of the sinuses are quiet, balloon sinuplasty may be a more targeted alternative.
What it involves
- Almost always under general anaesthetic
- Performed entirely through the nostrils with an endoscope, so no cuts or bruises on the face
- Takes 30 minutes to 2 hours depending on the extent of disease
- Usually a day case, home 3 to 4 hours after theatre
- A dissolvable dressing (a black, jelly-like sponge) may be placed and comes away after a few days
Recovery
- Blood-stained discharge for the first two weeks is normal
- The nose feels blocked, like a heavy cold, for 10 to 14 days
- Nasal steroid drops or sprays and saline rinses are used at home
- Do not blow your nose for 48 hours, then blow gently; sneeze with your mouth open
- Most people take about two weeks off work
Risks
Most cases are straightforward. Uncommon risks include a heavier nosebleed (about 1 in 100) and a sinus infection needing antibiotics (about 1 in 100). Because the sinuses sit close to the eye socket and the base of the skull, there are rare risks (around 1 in 1,000) of injury to the eye area or a leak of fluid from around the brain. These are very uncommon and are discussed in full before you decide to go ahead.
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This page is general information and not a substitute for individual medical advice. The right treatment depends on your assessment.