Functional Endoscopic Sinus Surgery (FESS)

Functional endoscopic sinus surgery, or FESS, is a surgical procedure in which the sinuses are opened via the nostrils. This operation has evolved significantly over the past decade because of a better understanding of the disease, as well as improved instrumentation, imaging, intra-operative techniques and anesthetics.

FESS examination

The FEES test is performed in the ENT Clinic with full wakefulness by an ENT physician and a speech therapy clinician, during which a flexible, thin fiber is inserted through the nose into the larynx up to the vocal cords are viewed on the screen.
Food is colored with a special blue dye, in different textures (solid, porous and liquid)

During swallowing, bolus of the food progressing on the screen. The process is being recorded, the rate and extent of the food bolus clearance and penetration into the airway observed. The examination involves some unpleasantness and requires the child's cooperation. Apart from the discomfort children have anxiety about the very insertion of optical fiber into the nose. In order to reduce the discomfort of the nose, sprayed with spray that is local anesthetic.

For children older than five years, it is important to prepare at home before the test and to explain to the child what is going to be done in the various stages, with emphasis on positive reinforcement. It is important to emphasize to the child the need to eat and swallow during the test. Otherwise, the test is not informative. It is very desirable to bring food from home (in different textures) that is loved by the child. This test cannot be performed with general anesthesia or anesthesia.

Until the age of 2-2.5 years, the examination is performed by holding the child in the direction that there is no cooperation, but most of the time they succeed in performing the examination and the child manages to eat while performing it. It is not necessary to fast but it is desirable for the child to get hungry for testing, which will increase the chances of success.

Why Is the Surgery Performed

With these improvements and more supervision after surgery, patients are experiencing excellent outcomes from FESS. Patients who make good candidates for functional endoscopic sinus surgery typically undergo a medical therapy trial before proceeding to surgical intervention.

How It‘s Performed

Our surgeons take pride in their meticulous approach to performing sinus surgery and have been trained extensively on all aspects of the procedure. The surgical approach used in FESS has changed quite a bit in the past 10 years and surgeons are now focused on opening the diseased sinuses while restoring function to the sinus cavity.

The days are over when surgeons would complete a sinus scrape and the patient’s condition barely improved. During the procedure nowadays, the surgeon opens the diseased sinuses before washing them and monitoring them after surgery. It is common for intra-operative imaging to be used during surgery when an inflammatory disease also needs to be cleared.

Expected Results

After functional endoscopic sinus surgery, patients do not typically have their nose packed. In the past, removing the nasal pack caused the severe discomfort from this procedure. Innovations in surgical methods and anesthetics have made it possible for patients to rarely experience bleeding during or after the operation. As a result, patents are usually discharged on the same day but occasionally stay overnight depending on the time of the surgery.

Leading spcialists

Prof. Ziv Gil

Director, Department of Otolaryngology-Head & Neck Surgery, Head and Neck Center.

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