Functional Endoscopic Sinus Surgery

About Functional Endoscopic Sinus Surgery

Functional endoscopic sinus surgery, or FESS, is performed through the nostrils using rigid endoscopes and fine instruments, with no external incision. Its aim is to open the natural drainage pathways of the paranasal sinuses and remove obstructing tissue such as polyps, restoring ventilation and normal mucus clearance. The main indication is chronic rhinosinusitis with or without nasal polyps that persists despite appropriate medical therapy, along with recurrent acute sinusitis, fungal sinus disease and some tumors. The extent of surgery is tailored to the disease and can range from limited opening of a single sinus to complete clearance of all sinuses. The concept was developed in Europe in the 1970s and 1980s by Walter Messerklinger and Heinz Stammberger and was popularized in the United States by David Kennedy, who coined the term FESS. Image guided navigation systems help surgeons operate near the eye and skull base. The same endoscopic techniques have since been extended to surgery on the skull base and pituitary gland.