Nose Treatment

Fess (Functional Endoscopic Sinus Surgery)

Functional Endoscopic Sinus Surgery (FESS) permits the direct visualization and treatment of various parts of the nasal cavities and sinuses which are otherwise inaccessible surgically.

Indications

  • Cases of sinusitis, anosmia, nasal obstruction.
  • Biopsy of nasal and nasopharyngeal tumours.
  • Evaluation of epistaxis of unknown origin.
  • Evaluation of cerebrospinal fluid rhinorrhea.
  • To evaluate the nasal cavity after surgery and surgical resections like radical maxillectomy.
Image

Hirschmann (1903) is considered the father of endoscopy.

Therapeutic:
  • Chronic sinusitis
  • Antrochoanal and Ethmoidal polyposis
  • Cauterization of bleeders in epistaxis
  • Closure of CSF rhinorrhoea leaks
  • Optic nerve de-compression
  • Rhinolith and foreign body removal
  • Intranasal Dacryocystorhinostomy (DCR)
  • Removal of nasal masses such as Rhinosporidiosis and Angiofibroma in expert hands
  • Choanal atresia
  • Turbinoplasty
  • Trans-Sphenoidal Pituitary tumours and Anterior skull base tumours
Aim of Functional Endoscopic Sinus Surgery (FESS):

The main aim of Functional Endoscopic Sinus Surgery (FESS) is to remove the diseased mucosa to relieve obstruction and restore natural sinus drainage, physiology and ventilation.

Minor Complications Major Complications
  • Septal or mucosal adhesions.
  • Orbital emphysema.
  • Epiphora.
  • Bleeding.
  • Blindness or loss of vision.
  • CSF leak.
  • Meningitis.
  • Intracranial bleed.
  • Damage to the internal carotid artery.
  • Vasovagal collapse.

However it must be noted that complications are markedly reduced in skillful hands and with newer good instruments and imaging techniques.

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