Major advances have
been made in the surgical treatment with a minimally invasive technique
called functional endoscopic sinus surgery (FESS).
sinus surgery is done to clear obstructions, including any polyp,
and ventilation and drainage to facilitate healing.
Candidates for the
- It is considered to be a good choice
for people with chronic sinusitis associated with structural abnormalities.
- Studies have found it to be safe
and effective in children with chronic sinusitis or whose sinuses
have not developed.
- The procedure may help HIV patients
with chronic or recurrent sinusitis.
- Candidates who have both sinusitis
and asthma have found the procedure beneficial.
- Functional endoscopic sinus surgery
has benefited patients with the ASA triad, fungus infections,
or severe chronic sinusitis.
Children require general
anesthetic, though adults will need only a local anesthetic for
Some physicians are
now using a device called a depth of field image (DOFI) video enhancement
screen that displays a holographic 3-D image. It allows the surgeon
an excellent view of the sinus cavities helping him work with very
little or no complications. A computed tomography scan is taken
for planning the procedure and as a guide to the sinuses during
In functional endoscopic
sinus surgery a flexible tube, a miniature camera, and a fiberoptic
light source are inserted through a single small opening.
Instruments like microdebrider,
which uses a blade on a tiny rotor, are effectively and safely used
to remove the polyps without harming the sinus area.
Very few serious complications
of FESS have been reported.
After surgery, it is
recommended that the patient should flush the sinuses twice daily
with a saline or alkaline solution, preferably using a system like