FESS – Functional Surgery for Chronic Sinusitis

What is Chronic Sinusitis? How can surgery help with treatment?

What is Functional Endoscopic Sinus Surgery for the Treatment of Chronic Sinusitis?

Functional Endoscopic Sinus Surgery, also known as FESS, is a minimally invasive surgical procedure designed to treat chronic sinusitis by restoring the natural drainage of the paranasal sinuses and improving nasal ventilation. Performed by Dr. José Eduardo Marcondes, an otolaryngologist (ENT) with extensive experience in endoscopic surgery, this technique uses high-precision instruments and endoscopes to access the paranasal sinuses through the nostrils, without the need for external incisions, promoting a faster and more comfortable recovery for the patient.

What is Chronic Sinusitis?

Chronic sinusitis is a persistent inflammation of the paranasal sinuses – cavities located around the nose, eyes and cheeks – that usually lasts more than 12 weeks, even with proper treatment. This condition occurs when there is prolonged obstruction or inflammation of the drainage pathways of the sinuses, frequently caused by recurrent infections, nasal polyps, deviated septum, allergic factors and as a post-COVID sequela.

Symptoms of Chronic Sinusitis

The symptoms of chronic sinusitis can vary in intensity, but generally include:

• Persistent nasal obstruction, with difficulty breathing through the nose;
• Thick or purulent nasal discharge, which may run from the nose or, more commonly, down the back of the throat;
• Facial pain or a sensation of pressure in the paranasal sinuses, especially around the eyes, cheeks and forehead;
• Reduced sense of smell and taste, affecting the enjoyment of meals;
• Chronic cough, fatigue and recurrent headaches, which interfere with daily activities and sleep;
• Episodes of low-grade fever and general malaise in cases of superimposed acute infections.
• Bad breath or a foul odor in the nose

Treatments for Chronic Sinusitis

The treatment of chronic sinusitis is initially conservative and aims to control inflammation and improve drainage. In the office, we begin with a detailed evaluation to personalize the treatment plan, which may include:

• Medications such as nasal corticosteroids, antibiotics (when there is a bacterial infection) and antihistamines for allergies;
• Nasal rinses with saline solutions to clean the airways;
• Supportive therapies, such as environmental control for allergens and immunotherapy in selected cases.

These treatments are effective for many patients, but when there is no significant improvement after therapy, surgical treatment is considered to restore nasal function in a lasting way.

Surgical Treatment: Indications for FESS

Functional Endoscopic Sinus Surgery is indicated for patients with chronic sinusitis refractory to clinical treatment, especially those with anatomical changes or polyps that prevent adequate drainage. Dr. José Eduardo Marcondes, with his technical expertise and extensive experience, recommends this surgery for cases such as:

• Chronic sinusitis with persistent symptoms despite the use of medications;
• Presence of nasal polyps or other obstructions that cause recurrent infections;
• Deviated septum or turbinate hypertrophy, which cause changes and aggravate inflammation;
• Patients seeking a definitive solution to improve their quality of life, with an emphasis on predictable results and minimizing risks.

How Does the Surgery Work?

FESS is performed under general anesthesia, lasting approximately 1 to 2 hours, depending on the complexity of the case. Using high-definition endoscopes and microsurgical instruments, the surgeon accesses the paranasal sinuses through the nostrils, without cuts to the skin. The procedure involves the careful removal of inflamed tissue, polyps or obstructions, widening the natural openings of the sinuses to restore drainage and ventilation.

Benefits of Functional Endoscopic Sinus Surgery:

FESS offers significant benefits, with a high success rate in resolving symptoms and preventing recurrences. Among the main advantages are:

• Lasting improvement in nasal breathing, reducing congestion and facilitating daily and physical activities;
• Reduction of recurrent infections, with a decrease in acute sinusitis and antibiotic use;
• Relief of facial pain and headaches, contributing to overall well-being and better sleep quality;
• Fast recovery, with less swelling, bleeding and time off work, thanks to the minimally invasive approach;
• Restoration of smell and taste, improving sensory enjoyment and quality of life.

Each surgery is planned with a focus on technical excellence and individualized care, ensuring that patients feel supported throughout their journey toward a healthier and fuller life.