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Endoscopic Sinus Surgery The Procedure and Recovery Process

Medically reviewed by Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP — By Catherine Crider on September 27, 2022Sinus infections impact 31 million people in the United States. For those with frequent sinus issues, it can be hard to enjoy scents or even breathe easily. While medications can help temporarily, reoccurring sinus infections or growths that block your sinuses might require sinus surgery. This article will explain more about endoscopic sinus surgery and how the procedure works. It will also explore questions or concerns you may wish to consult your healthcare team about when considering this type of surgery.

What is endoscopic sinus surgery

Endoscopic sinus surgery is a procedure to remove blockages in the sinuses. Doctors may also refer to it as functional endoscopic sinus surgery. During this procedure, your doctor will use an endoscope, a thin camera rod with a light at the end, to better see the sinuses. They’ll also typically insert special surgical equipment through the nostrils during the procedure. This allows for the opening of your natural drainage pathways, removing any blockage.

Why is this sinus surgery necessary

Doctors may use endoscopic sinus surgery to address:chronic and recurrent sinus inflammation or infectionsnasal polyps, which are noncancerous growths nasal tumorsnasal congestion and obstruction Goals of endoscopic sinus surgery can include:reducing the frequency and intensity of sinus infectionsincreasing the amount of airflow through the noseimproving the sense of smelldelivering medication and nasal rinses to the sinus cavities Doctors generally recommend functional endoscopic sinus surgery when there are significant physical problems to address. In cases where a doctor is just hoping to facilitate drainage, they may do a balloon sinuplasty to enlarge a blocked sinus passage. Doctors may suggest a balloon sinuplasty because they can typically perform it in their office, while functional endoscopic sinus surgery is generally an outpatient surgery. The recovery time for a balloon sinuplasty is also usually shorter. Not all doctors recommend balloon sinuplasty, though, because they may not believe it’s an adequate surgical option. It’s also not appropriate when the doctor needs to remove tissue.

Is endoscopic sinus surgery safe

Endoscopic sinus surgery is minimally invasive because doctors perform it entirely through the nostrils. Most individuals can return home the same day. The surgery presents a small risk of complications relating to the eyes or the base of the skull, such as a leak of cerebrospinal fluid. There are also some other risks to be aware of, including:infectionexcessive bleeding developing a hole through the septumvision lossthe need for future surgeries Doctors typically use general anesthesia during this procedure, which also carries some risks. Your healthcare team will discuss these with you before your surgery.

How effective is endoscopic sinus surgery

According to an older article from 2012, endoscopic sinus surgery showed a success rate of 80% to 90% in the treatment of chronic sinusitis in studies that followed individuals for 18 months after surgery. It’s important to note, though, that you may require follow-up surgeries as time passes and may still experience sinus infections after the surgery. A key factor influencing patient satisfaction following endoscopic sinus surgery appears to be setting appropriate expectations before the procedure, so you’ll want to talk with your doctor about the results that are reasonable to expect. Advancements in the area of endoscopic sinus surgery continue to make it more effective. For example, researchers have found that the surgery appears to have better results when paired with treatments like the nasal spray triamcinolone.

What to expect during recovery

After surgery, you can expect the following:Swelling around your nose, upper lip, cheeks, and eyes.You may feel like you have a bad head cold.You’ll also have a drip pad under your nose to collect mucus and blood.Avoid putting anything in your nose following the procedure and avoid blowing your nose for 2 weeks Congestion and swelling should significantly improve within a week or two. You may be ready to return to work or school a week or so after the procedure.Your doctor may ask you to use large amounts of saline wash to irrigate the sinuses, and they may prescribe medication to help with potential pain and infections. These might include topical and oral steroids. Alternatively, a doctor may place stents that gradually release steroids into the nose, sinuses, or both at the time of surgery and remove them after the postoperative period. You should check with your doctor before using any over-the-counter medications.Your sense of smell will typically not be as good after surgery but should return within a month or two.It’s a good idea to avoid lifting anything heavier than 10 pounds in the first week after surgery. Additionally, you should avoid flying for at least 2 weeks and swimming for 6 weeks. Most people feel back to themselves again within a month or two of the procedure, but your doctor may continue to follow up with you for 3 to 4 months to make sure your sinuses are healing properly.

What does this sinus surgery cost

A 2021 study suggests that the cost of endoscopic sinus surgery ranges from $3,600 to more than $10,500. Part of the reason for this wide variation is that endoscopic sinus surgery may include a number of procedures that cause the surgery to take longer and require additional supplies. The exact cost can also depend on where you have the surgery and the health insurance you have. Insurance codes for this procedure vary depending on diagnosis, whether one or both sides of the nose receive treatment, and any removals needed. You may see multiple procedure codes ranging from 31231 to 31298 on your bill.

Takeaway

If you are experiencing recurrent sinus infections or have a blockage in your sinuses that impacts your ability to smell and breathe, your doctor may suggest endoscopic sinus surgery. This outpatient surgery involves inserting a camera scope through your nostril along with any surgical equipment needed to clear out your sinus pathways. Any medical procedure has a variety of risks. You’ll want to consult with your doctor and care team about any concerns you have before the surgery and follow any directions for your recovery afterward. Last medically reviewed on September 27, 2022

How we vetted this article

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Achar P, et al. (2012). Endoscopic dilatation sinus surgery (FEDS) versus functional endoscopic sinus surgery (FESS) for treatment of chronic rhinosinusitis: A pilot study.
ncbi.nlm.nih.gov/pmc/articles/PMC3546409Code FESS with a clear head. (2020).
aapc.com/blog/49499-code-fess-with-a-clear-head/Hao Z, et al. (2022). The efficacy of functional endoscopic sinus surgery combined with triamcinolone acetonide aqueous nasal spray for the treatment of chronic rhinosinusitis.
10.3389/fsurg.2022.855618Homsi MT, et al. (2021). Sinus endoscopic surgery.
ncbi.nlm.nih.gov/books/NBK563202/Khademi S, et al. (2022). A review of the revisions and complications management procedure in sinus surgery.
ncbi.nlm.nih.gov/pmc/articles/PMC9051709/Saydy N, et al. (2021). Patient perspectives on endoscopic sinus surgery for chronic rhinosinusitis.
10.1186/s40463-021-00515-zSinus infection. (n.d.)
acaai.org/allergies/allergic-conditions/sinus-infection/Tajudeen BA, et al. (2017). Thirty years of endoscopic sinus surgery: What have we learned?
10.1016/j.wjorl.2016.12.001Yim M, et al. (2021). The value of endoscopic sinus surgery in chronic rhinosinusitis.
onlinelibrary.wiley.com/doi/10.1002/lio2.523Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Current Version Sep 27, 2022 By Catherine Crider Edited By Mike Hoskins Medically Reviewed By Nicole Aaronson, MD, MBA, CPE, FACS, FAAP Copy Edited By Kate Phelan Share this articleMedically reviewed by Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP — By Catherine Crider on September 27, 2022

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