Purpose: Functional endoscopic sinus surgery (FESS) is intended for people with chronic sinus problems who do not respond to medical therapy. The endoscope provides superior lighting and magnification in order to visualize the deep recesses of the nasal cavities and sinuses. The advantages of the procedure are that in general, the surgery is less extensive, there is often less removal of normal tissue, external incisions are usually not required, and the surgery can frequently be performed as an outpatient.

POSSIBLE ADVERSE EFFECTS:

Known potential adverse effects include:
1. Bleeding: In a small percentage of cases nasal packing may be necessary in order to control bleeding. If there is extensive disease present, the procedure may be staged in order to provide maximal safety and prevent excessive blood loss. Every effort will be made to avoid blood transfusion.

2. Adhesions: When raw surfaces of mucosa heal, adhesions (scar tissue) may form. These are rarely of any significance. The original condition may return when there is complete obstruction of the middle meatus. A revision procedure may be required.

3. Recurrent polyp formation: The surgery is designed to remove the polyps that are present and thereby relieve the obstruction. Medical management in the form of tablets, nasal sprays, or allergy shots may be necessary in order to prevent polyps from returning.

4. Periorbital brusing or swelling: Mild brusing or swelling around the eye may be seen in a small number of patients. This will usually resolve in 10-14 days and cause no visual problems. A more serious bleed may require an additional procedure to control. You will be instructed not to blow your nose after surgery in order to decrease the risk.

5. There are risks involved with general anesthesia, but are uncommon. You may discuss these with the anesthesiologist before surgery.

6. Blockage of tear duct: If the bone surrounding the tear duct is injured either by the disease process or during surgery, an additional procedure may be required to re-establish the flow of tears away from the eye.

7. Visual change or loss: Temporary changes in vision and blindness have been reported. This risk has been decreased with the advent of superior lighting and visualization provided by the endoscope when compared to classical sinus surgery.

8. Spinal fluid leakage: The disease process may make the bone extremely thin in the upper aspect of the nasal cavity. Should leakage of spinal fluid occur, it will be repaired at the time of surgery. This rarely causes any further problems after surgery. You will be placed on antibiotics after surgery.

9. Tooth pain and numbness: This is a rare problem. When it occurs, most cases are temporary in nature.