Functional Endoscopic Sinus Surgery (FESS)
What is Functional Endoscopic Sinus Surgery (FESS)?
Functional Endoscopic Sinus Surgery (FESS) is a minimally invasive procedure to treat chronic sinusitis, nasal polyps, or other sinus-related conditions by using an endoscope to clear blockages and restore normal sinus drainage. It’s commonly performed when medical treatments fail. In India, FESS is conducted in ENT departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need FESS?
FESS is indicated for:
- Chronic sinusitis:
- Persistent symptoms (>12 weeks): Nasal congestion, facial pain, headache, or discharge despite medical treatment (e.g., antibiotics, nasal steroids).
- Nasal polyps:
- Growths blocking sinus drainage, causing congestion or loss of smell.
- Sinus obstructions:
- Deviated septum, concha bullosa, or other anatomical blockages.
- Recurrent infections:
- Frequent acute sinus infections (4+ episodes/year).
- Complications:
- Sinus infections spreading to eyes or brain (e.g., orbital cellulitis, rare).
The procedure aims to remove blockages, widen sinus openings, and improve drainage, thereby reducing infections, relieving symptoms, and enhancing quality of life.
Why Do FESS Costs Vary in India?
Costs range from ₹40,000 to ₹1.2 lakh :
- Procedure Complexity: Simple FESS (₹40,000–₹70,000); extensive (e.g., with septoplasty: ₹70,000–₹1.2 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹70,000–₹1.2 lakh); lower in government hospitals (AIIMS: ₹10,000–₹30,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced ENT surgeons charge more.
- Additional Costs: Anesthesia (₹5,000–₹15,000), hospital stay (₹5,000–₹10,000/day), medications (₹2,000–₹5,000), nasal packs (₹1,000–₹3,000).
- Insurance: Covered for medical necessity (e.g., chronic sinusitis); confirm with your provider.
FESS Procedure
- Before Surgery Evaluation:
- Diagnosis:
- Nasal endoscopy: Visualizes sinus openings, polyps, or discharge.
- CT scan: Assesses sinus anatomy, extent of disease, and blockages.
- Blood tests: Blood sugar, clotting profile.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe.
- Consent: Risks, including bleeding, are explained.
- Diagnosis:
- Surgical Techniques:
- FESS:
- Performed under general anesthesia (sometimes local with sedation), lasting 1–2 hours.
- Endoscope: A thin, rigid scope (4 mm) with a camera is inserted through the nostrils (no external incisions).
- Sinus clearance:
- Microdebrider or forceps remove polyps, inflamed tissue, or bone blocking sinus openings (e.g., maxillary, ethmoid sinuses).
- Sinus ostia (openings) are widened to improve drainage.
- Deviated septum (if present) may be corrected (septoplasty).
- Irrigation: Saline clears debris; hemostatic agents control minor bleeding.
- Packing: Nasal packing (dissolvable or removable) may be used to control bleeding (removed in 1–3 days if non-dissolvable).
- Intraoperative Tools:
- Endoscope: Visualizes sinuses.
- Microdebrider: Removes tissue precisely.
- Forceps: Clears polyps or bone fragments.
- FESS:
- After Surgery:
- Hospital stay: Same-day discharge or 1 day.
- Care: Nasal saline irrigation (2–3 times daily) to keep sinuses clean; avoid blowing nose for 1 week.
- Pain management: Mild to moderate discomfort for 3–5 days; managed with acetaminophen.
- Instructions: Avoid strenuous activity for 2 weeks; sleep with head elevated to reduce swelling.
Recovery After FESS
- Hospital Stay: Same-day discharge or 1 day.
- Post-Surgery Care:
- Discomfort: Mild nasal congestion, headache, or crusting for 1–2 weeks; managed with saline irrigation.
- Bleeding: Minor nasal bleeding or discharge for 3–5 days; use drip pad if needed.
- Activity: Rest for 2–3 days; avoid heavy lifting or strenuous activity for 2 weeks.
- Nasal care: Saline sprays or irrigation for 4–6 weeks; avoid smoking or irritants.
- Symptom relief: Breathing improves in 1–2 weeks; smell/taste may take 1–3 months.
- Follow-Up:
- Visits at 1 week (remove packing if used), 2 weeks, and 1 month for nasal debridement (clean crusts).
- Endoscopy: At 1 month to check sinus healing.
Most resume normal activities in 3–7 days; full recovery takes 4–6 weeks. Success rate: 80–90% achieve significant symptom relief; recurrence of polyps or infections may occur in 10–20% over 5 years.
Risks and Complications
- Surgical Risks:
- Bleeding (2–5%): Minor nasal bleeding common; severe bleeding (<1%) may need packing or cauterization.
- Infection (1–2%): Sinus or nasal infection; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to general anesthesia; rare in healthy patients.
- Post-Surgery:
- Scarring (1–3%): Adhesions between nasal tissues; may need revision surgery.
- Change in smell (1–2%): Temporary or permanent (rare); improves in 1–3 months for most.
- CSF leak (<0.5%): Rare; skull base injury may leak cerebrospinal fluid; needs urgent repair.
- Orbital injury (<0.5%): Rare; damage to eye structures (e.g., double vision); needs immediate attention.
- Long-Term:
- Recurrence (10–20% over 5 years): Polyps or sinusitis may return; managed with medications or revision FESS.
Report heavy bleeding, severe headache, vision changes, or fever promptly.
Frequently Asked Questions (FAQs)
What causes chronic sinusitis?
Allergies, nasal polyps, deviated septum, infections, or anatomical blockages.
Can I avoid FESS?
Yes, if mild: Nasal steroids, saline irrigation, or antibiotics; FESS is for persistent or severe cases.
Is FESS painful?
Mild to moderate discomfort for 3–5 days, managed with medication; nasal congestion improves in 1–2 weeks.
How soon can I resume activities?
Normal activities: 3–7 days; full recovery: 4–6 weeks; avoid strenuous activity for 2 weeks.
Is FESS covered by insurance in India?
Yes, for medical necessity; confirm with your provider.
Signs of complications?
Heavy bleeding, severe headache, vision changes, or fever.
Will my symptoms fully resolve after FESS?
80–90% see significant improvement; recurrence possible (10–20%) if underlying issues (e.g., allergies) persist.
Lifestyle changes post-surgery?
Continue nasal irrigation, avoid irritants (e.g., smoke), manage allergies, and attend follow-ups.
Conclusion
FESS is a safe and effective procedure to relieve chronic sinusitis and related conditions, with a high success rate and minimal invasiveness. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult an ENT surgeon for personalized guidance.
Looking for Best Hospitals for FESS
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
40,000 |
1,30,000 |
Ahmedabad |
50,000 |
1,50,000 |
Ajmer |
40,000 |
1,30,000 |
Aligarh |
40,000 |
1,30,000 |
Allahabad |
40,000 |
1,30,000 |
Amritsar |
45,000 |
1,40,000 |
Aurangabad |
45,000 |
1,40,000 |
Bangalore |
50,000 |
1,50,000 |
Bareilly |
40,000 |
1,30,000 |
Belgaum |
45,000 |
1,40,000 |
Bhopal |
45,000 |
1,40,000 |
Bhubaneswar |
45,000 |
1,40,000 |
Bikaner |
40,000 |
1,30,000 |
Chandigarh |
50,000 |
1,50,000 |
Chennai |
50,000 |
1,50,000 |
Coimbatore |
50,000 |
1,50,000 |
Dehradun |
45,000 |
1,40,000 |
Delhi |
50,000 |
1,50,000 |
Dhanbad |
40,000 |
1,30,000 |
Durgapur |
40,000 |
1,30,000 |
Faridabad |
50,000 |
1,50,000 |
Ghaziabad |
50,000 |
1,50,000 |
Gorakhpur |
40,000 |
1,30,000 |
Guntur |
45,000 |
1,40,000 |
Gurgaon |
50,000 |
1,50,000 |
Guwahati |
45,000 |
1,40,000 |
Gwalior |
40,000 |
1,30,000 |
Hyderabad |
50,000 |
1,50,000 |
Indore |
45,000 |
1,40,000 |
Jabalpur |
40,000 |
1,30,000 |
Jaipur |
50,000 |
1,50,000 |
Jalandhar |
45,000 |
1,40,000 |
Jamshedpur |
45,000 |
1,40,000 |
Jodhpur |
40,000 |
1,30,000 |
Kanpur |
40,000 |
1,30,000 |
Kochi |
50,000 |
1,50,000 |
Kolkata |
50,000 |
1,50,000 |
Kollam |
45,000 |
1,40,000 |
Lucknow |
45,000 |
1,40,000 |
Ludhiana |
50,000 |
1,50,000 |
Madurai |
45,000 |
1,40,000 |
Mangalore |
45,000 |
1,40,000 |
Meerut |
40,000 |
1,30,000 |
Moradabad |
40,000 |
1,30,000 |
Mumbai |
50,000 |
1,50,000 |
Mysore |
50,000 |
1,50,000 |
Nagpur |
45,000 |
1,40,000 |
Nashik |
45,000 |
1,40,000 |
Navi Mumbai |
50,000 |
1,50,000 |
Noida |
50,000 |
1,50,000 |
Patna |
40,000 |
1,30,000 |
Pune |
50,000 |
1,50,000 |
Raipur |
45,000 |
1,40,000 |
Rajkot |
45,000 |
1,40,000 |
Ranchi |
40,000 |
1,30,000 |
Surat |
50,000 |
1,50,000 |
Thane |
50,000 |
1,50,000 |
Vadodara |
45,000 |
1,40,000 |
Varanasi |
40,000 |
1,30,000 |
Visakhapatnam |
45,000 |
1,40,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.