Functional Endoscopic Sinus Surgery (FESS)
Endoscopic opening of the sinus drainage pathways through the nostrils, preserving healthy mucosa. Used for chronic sinusitis and polyposis that has not responded to an adequate course of medical treatment.
Sinus Surgery
Sinus & Nasal
Endoscopic sinus and nasal surgery for chronic sinusitis, nasal polyps, fungal sinus disease and a blocked nose — after medical treatment has been given a fair trial.
Chronic sinus problems are among the most over-operated conditions in ENT, and among the most commonly mistreated. A blocked nose, facial pressure and post-nasal drip can arise from infection, allergy, structural narrowing, or a combination — and each calls for a different response. Dr. Satish Babu performs the full range of endoscopic sinus surgery, from standard FESS through to fungal and paediatric sinus disease, but the starting point in clinic is a nasal endoscopy and, where indicated, a CT scan to establish what is actually driving the symptoms. A great many patients who arrive expecting surgery are treated successfully without it.
What Is FESS (Functional Endoscopic Sinus Surgery)?
Functional Endoscopic Sinus Surgery is performed entirely through the nostrils using an endoscope, with no external incisions and no facial scars. The aim is functional rather than merely removing tissue: the natural drainage pathways of the sinuses are opened so that the sinus can clear itself and ventilate normally, while healthy mucosa is preserved. This matters, because the sinus lining is what clears mucus and traps infection — stripping it causes long-term problems. FESS is used for chronic sinusitis that has not responded to medical treatment, for nasal polyps, for fungal sinus disease, and to access the sinuses in more complex procedures. Balloon sinuplasty is a less invasive variant in which a small balloon dilates the sinus opening without removing tissue, suitable for selected cases. Septoplasty, often performed alongside, straightens a deviated nasal septum to relieve structural obstruction.
See a specialist if
Symptoms That Should Be Assessed
- Nasal blockage lasting more than twelve weeks
- Facial pain, pressure or heaviness around the cheeks and eyes
- Thick nasal discharge or persistent post-nasal drip
- Reduced or absent sense of smell
- Repeated sinus infections through the year
- Headache that worsens on bending forward
- Snoring or mouth-breathing caused by a blocked nose
- One-sided nasal blockage or blood-stained discharge (needs prompt assessment)
Diagnosed and managed here
Conditions Treated
- Chronic rhinosinusitis with and without nasal polyps
- Recurrent acute sinusitis
- Allergic rhinitis and allergic fungal sinusitis
- Fungal sinusitis and fungal granuloma
- Deviated nasal septum
- Turbinate hypertrophy
- Paediatric sinusitis and polyposis
- Sinonasal tumours (benign and malignant)
- Nasal obstruction from structural causes
What is involved
Procedures Performed
Septoplasty
Correction of a deviated nasal septum to relieve structural nasal obstruction. Frequently combined with turbinate reduction where both contribute to blockage.
Turbinate Reduction (LASER-Assisted)
Reduction of enlarged inferior turbinates to improve nasal airflow, using LASER or radiofrequency techniques that preserve turbinate function rather than removing the structure.
Balloon Sinuplasty
Dilation of the sinus opening with a small balloon, without tissue removal. A less invasive option for selected patients with limited disease.
Endoscopic Polypectomy
Endoscopic removal of nasal polyps, typically combined with FESS and followed by medical treatment to reduce the likelihood of recurrence.
Fungal Sinus Surgery
Endoscopic clearance of fungal disease from the sinuses, including allergic fungal sinusitis and fungal granuloma, with appropriate medical therapy afterwards.
Before You Agree to an Operation
When Sinus Surgery May Not Be Needed
Sinus surgery is appropriate when medical treatment has been given a proper trial and failed, or where there is a structural problem medication cannot fix. It is not the first step. These are the situations in which conservative management is usually the right course.
- Acute sinusitis — even when severe and recurrent — is a medical problem. It is treated with antibiotics, nasal steroids and saline irrigation, not surgery.
- Chronic sinusitis is generally only considered for surgery after an adequate trial of medical therapy, which usually means several weeks of nasal steroid spray and saline irrigation, not a few days of antibiotics.
- Allergic rhinitis frequently mimics sinusitis. Where allergy is the driver, allergen avoidance, antihistamines and intranasal steroids address the cause; surgery does not.
- A deviated septum seen on a scan is not in itself a reason to operate. Many people have one and breathe perfectly well. Surgery is for a septum causing genuine symptomatic obstruction.
- Sinus headache is frequently migraine. Migraine responds to migraine treatment, and operating on the sinuses will not relieve it — which is why the pattern of the headache is worth examining carefully before surgery is discussed.
- Nasal polyps often shrink substantially with steroid treatment, and medical management may control them for long periods without an operation.
- Incidental findings on a CT scan requested for another reason are common and frequently harmless. A scan showing mucosal thickening in someone without symptoms is not grounds for surgery.
Common questions
Do I actually need sinus surgery?+
Usually not as a first step. Sinus surgery is generally considered when symptoms have persisted despite an adequate trial of medical treatment — typically several weeks of nasal steroid spray and saline irrigation, not a short antibiotic course — or where there is a structural problem, extensive polyps, or fungal disease that medication cannot clear. A nasal endoscopy and, where indicated, a CT scan establish which category you fall into. If medical treatment has not yet been properly tried, that is the place to begin.
Is FESS painful, and how long is the recovery?+
FESS is performed under general anaesthesia, so nothing is felt during the procedure. Afterwards most patients describe congestion and pressure rather than significant pain, controlled with simple analgesia. Most people return to desk work within about a week. Saline irrigation and follow-up endoscopic cleaning are important in the first few weeks, and the full benefit in smell and breathing often takes several weeks to settle.
Will my nasal polyps come back after surgery?+
Polyps can recur, particularly where there is underlying allergy, asthma or aspirin sensitivity. Surgery removes the polyps present and opens the sinuses; it does not cure the inflammatory tendency that produced them. Continuing medical treatment after surgery — usually nasal steroids and irrigation — is what keeps recurrence at bay, and stopping treatment once breathing improves is the most common reason polyps return.
Are there scars on the face after sinus surgery?+
No. Endoscopic sinus surgery is performed entirely through the nostrils using an endoscope. There are no external incisions and no facial scars.
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