Your Guide to Functional Endoscopic Sinus Surgery (FESS): What to Expect Before, During, and After
For many individuals in Singapore suffering from persistent sinus infections, nasal blockages, or chronic congestion, Functional Endoscopic Sinus Surgery (FESS) offers a practical, minimally invasive solution.
Understanding what this procedure entails can help lessen anxiety and empower patients to make informed decisions.
In this comprehensive guide, we walk through everything you need to know about Functional Endoscopic Sinus Surgery—from preparation and the day of the procedure to recovery and follow-up care.
Key Takeaways
- Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure done through the nostrils using an endoscope, a thin tube with a light and camera, so there are no external cuts or facial scars.
- It is often performed under general anaesthesia, with duration depending on the extent of surgery.
- FESS is usually considered when appropriate medical treatment has not adequately controlled symptoms.
- FESS may be considered for persistent sinus disease, nasal polyps or obstruction confirmed through assessment and imaging.
- Early recovery may include congestion and light bleeding, while return to work varies by the procedure and patient.
What is Functional Endoscopic Sinus Surgery (FESS)?
FESS is a minimally invasive procedure performed through the nostrils using a thin, flexible tube with a light and camera known as an endoscope. The surgeon uses this tool to diagnose and treat conditions inside the nasal passages and sinuses without needing external or facial incisions.
It is commonly recommended for patients with chronic rhinosinusitis, nasal polyps, or structural abnormalities obstructing sinus drainage. By opening blocked sinus pathways, the procedure aims to restore normal breathing and reduce the frequency of infections.
According to studies, this procedure has been shown to improve the quality of life in patients with chronic sinusitis.
Who Should Consider FESS?
An ENT specialist may recommend Functional Endoscopic Sinus Surgery for patients who:
- Experience persistent sinus infections despite appropriate medical therapy
- Suffer from nasal polyps or structural nasal issues
- Have abnormal findings on a CT scan or nasal endoscopy
- Deal with symptoms such as facial pain, pressure, postnasal drip, or congestion that interfere with daily life
Post-operative care plays a critical role in preventing complications and ensuring optimal healing. Proper aftercare speeds up recovery and reduces the likelihood of infection or recurrence.
It is not typically the first line of treatment. Most patients will have undergone weeks or months of nasal sprays, antihistamines, antibiotics, or steroid therapy before surgery is considered.
Patients with certain conditions (e.g., bleeding disorders, uncontrolled diabetes, or acute infections) may not be suitable candidates and should discuss these risks with their ENT doctor.
If you want to learn more about FESS, book a consultation with ENT specialist Dr Dennis Chua today.
Pre-Surgery Preparation: What to Expect
Initial Evaluation
Preparation begins with a detailed consultation. The ENT specialist will review your medical history, symptoms, and imaging results (such as a CT scan) and may perform a nasal endoscopy.
Before Surgery
- You may be advised to stop blood-thinning medications like aspirin a few days before the surgery.
- Fasting may be required for at least six hours prior to general anaesthesia.
- Have someone accompany you on the day of surgery, as you won’t be able to drive afterwards.
Clear communication with your surgeon is key. Use this time to ask questions, understand the risks and benefits, and feel confident about the next steps.
The Day of the Procedure
FESS is typically performed as an outpatient surgery under general anaesthesia. The procedure usually takes between two to three hours, depending on the complexity of the case.
What Happens During Surgery
- The surgeon inserts the endoscope into the nasal cavity to visualise the sinuses.
- Once the surgeon has located the problem, they will use specialised instruments alongside the endoscope to remove any blockages, polyps, or infected tissue.
- In more advanced cases, image-guided navigation may be used to improve precision.
There are no external cuts or scars, and bleeding is generally minimal. Because of the nature of the technique, surrounding healthy tissue is preserved.
Recovery: What to Expect After Surgery
Immediate Post-operative Period
- You will be observed for a few hours before being discharged.
- Mild discomfort, nasal stuffiness, and slight bleeding are normal in the first 24–72 hours.
There may also be some nasal and sinus pressure and pain for the first few days after surgery. Some also experience fatigue, so plan ahead if you need to take a break from work or other activities a week after the surgery. Patients may also experience nasal congestion and discharge after the surgery, but the symptoms should improve within two to three weeks.
Post-operative Care at Home
- Use prescribed nasal rinses (e.g., saline sprays) to keep the nasal passages clean and reduce the risk of crusting.
- Take any prescribed medications, such as antibiotics or corticosteroids, as instructed.
- Avoid blowing your nose or engaging in strenuous activity for at least a week.
- Sleep with your head elevated to reduce swelling.
Follow-Up Visits
Most patients return for several follow-up appointments within the first few weeks after the surgery to monitor progress and clean the area of fluid and blood left behind after surgery. Healing is usually completed within one to two months.
Risks and Complications
While FESS is generally safe, all surgical procedures carry some risks. These include:
- Bleeding: Most bleeding is minor and controlled easily.
- Infection: Rare when post-op instructions are followed.
- Scar tissue formation: May require further treatment.
- Eye complications or cerebrospinal fluid leak: Extremely rare but possible due to proximity to the eyes and brain.
Research shows that FESS is a relatively safe and standard procedure with a low complication rate. Patients are advised to immediately report any unusual symptoms such as severe headache, vision changes, or high fever to their ENT doctor.
Long-Term Outlook
Most patients experience significant improvement in symptoms following the surgery. However, those with recurring polyps or allergic fungal sinusitis may require long-term maintenance with nasal sprays or, in rare cases, revision surgery. Continued follow-up with your ENT specialist and adherence to treatment plans play a crucial role in long-term success.
Frequently Asked Questions About Functional Endoscopic Sinus Surgery (FESS)
- Is the surgery painful? Discomfort is usually mild and managed with over-the-counter pain relief.
- Will I need to stay in the hospital? Most patients go home the same day.
- Can I go back to work the next day? It’s best to rest for at least a few days; most return to work within a week.
- Will it cure my sinus problems permanently? The goal is long-term symptom relief, but ongoing care may be necessary, especially for those with underlying allergies or inflammation.
Learn About Functional Endoscopic Sinus Surgery (FESS)
FESS is a well-established treatment option for individuals with chronic sinus conditions. Removing obstructions and restoring natural drainage often provide long-lasting relief from symptoms that have not improved with medication alone.
Understanding what to expect at each step—before, during, and after surgery—can ease the decision-making process and support a smoother recovery.
If you are experiencing chronic sinus problems and looking for options for long-term relief, schedule a consultation with ENT specialist Dr Dennis Chua today.
If you have questions or concerns about your ears, nose, and throat,
you may book a consultation with Dr Dennis Chua, an ENT specialist in Singapore.
He has completed his training in otorhinolaryngology locally and attained qualifications internationally.
About Dr Dennis Chua
Dr. Dennis Chua is an Ear, Nose and Throat (ENT) specialist with more than a decade of experience. He is held in high regard within the field of Otolaryngology, having published many articles in peer reviewed journals on the topic of ENT.
As an ENT Specialist in Singapore, Dr Dennis Chua is committed to providing thorough, patient-centred care for both adults and children. Whether you’re managing allergies, sinus problems, hearing issues, or throat concerns, we take time to understand your condition and guide you through your treatment options.
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