Functional Endoscopic Sinus Surgery

Developed in the 1950’s, the nasal telescope has greatly changed the evaluation and treatment of rhinosinusitis. This instrument, which provides a view of the structures in the nose and sinuses, is used both in the operating room and in the office.

During initial office visits, the otorhinolaryngologist (ENT physician) will use the telescope for diagnosis. The telescope allows for better visualization within the nose and sinuses, and together with sinus CT scans, often reveals problems that otherwise would not be evident.

The nasal telescope also gives a view for “opening” the natural drainage passages during sinus surgery. These procedures are performed without facial incisions — since both the telescope and other instruments may be passed through the nostrils. Before nasal telescope, sinus surgery was often destructive and focused on the removal of so-called “diseased” tissue; however, today’s endoscopic procedures are performed with much more finesse.

These techniques generally eliminate the need for traditional external incisions — although in rare instances, the telescope may be used through an external incision.

Another important feature is that functional endoscopic sinus surgery focuses on treating the underlying cause of the problem. The ethmoid areas are usually opened; this then allows for visualization of the maxillary, frontal, and sphenoid sinuses. The sinuses can then be viewed directly, and diseased or obstructive tissue removed as necessary. There is often less removal of normal tissue, and thus healing is quicker and outcomes are better.

Recovery after the surgery is often faster than anticipated. The surgery is most commonly performed on an outpatient basis (or with a 23-hour hospital stay), and the patient may return to near normal activity in 1-2 weeks