Persistent symptoms
Symptoms such as nasal blockage, discharge, pressure or reduced smell have continued despite an appropriate period of treatment.
Rhinology · Gold Coast
Endoscopic sinus surgery
Endoscopic sinus surgery may be considered for selected patients with persistent sinus disease when appropriate medical treatment has not provided adequate control. The decision begins with a careful diagnosis—not with an assumption that surgery is required.
Assessment before procedure
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Medical options considered first
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Individual risks discussed
The procedure
What is endoscopic sinus surgery?
Endoscopic sinus surgery—sometimes called functional endoscopic sinus surgery or FESS—is performed through the nostrils using a small camera and specialised instruments. Its purpose is to improve access to and ventilation of the affected sinuses while preserving healthy tissue where possible.
The extent of surgery varies. It is guided by the underlying condition, examination findings and imaging rather than by a single standard operation. Some patients may also require treatment of nasal polyps or other contributing nasal problems.
A stepwise decision
When might surgery be considered?
Surgery is generally considered only after the diagnosis has been clarified and appropriate non-surgical treatment has been tried or discussed.
Objective findings
Nasal examination, endoscopy or CT imaging supports a diagnosis that may reasonably benefit from a surgical approach.
Shared decision-making
The likely benefits, limitations, alternatives and individual risks have been considered alongside the effect of symptoms on daily life.
Before a recommendation
What assessment may involve
Not every patient needs every investigation. The assessment is tailored to the symptoms, history and examination findings.
- A detailed history of symptoms, duration and previous treatment
- Examination of the nose and nasal airway
- Nasal endoscopy where clinically appropriate
- Review of allergy, asthma, dental or other contributing factors
- CT imaging where indicated for diagnosis or surgical planning
- Discussion of saline rinses, topical nasal treatment and other non-surgical options
Surgery is not the first step for everyone
Many sinus conditions are initially managed medically. An operation may not be recommended if the likely benefit is limited, the diagnosis remains uncertain or reasonable non-surgical treatment has not yet been completed.
After the procedure
Recovery and ongoing care
Recovery varies with the extent of surgery, the underlying condition and the individual patient.
Early recovery
Temporary congestion, discharge, fatigue and mild discomfort are common. Individual instructions are provided about activity, nose blowing and return to work.
Post-operative care
Saline rinses, prescribed nasal medication and follow-up cleaning or examination may form part of recovery, depending on the procedure.
Long-term management
Surgery does not remove every cause of sinus inflammation. Some patients require continued medical treatment and monitoring after recovery.
Informed consent
Risks and limitations
All surgery carries risk. The relevance of each risk depends on the planned procedure and the patient’s health, anatomy and underlying sinus disease. A personalised discussion is required before consent.
- Bleeding, infection, pain or temporary worsening of nasal blockage
- Scar tissue, persistent symptoms or recurrence of sinus disease
- Change in smell or taste
- Need for further medical treatment or additional surgery
- Uncommon but potentially serious complications involving the eye, vision, brain or leakage of fluid surrounding the brain
- General anaesthetic and individual medical risks
Benowa · Gold Coast
Discuss persistent sinus symptoms with a rhinology specialist
A consultation can help clarify the diagnosis and whether further medical treatment, investigation or surgery is appropriate. A GP referral is recommended.
Call (07) 5620 1030General references
This general information has been informed by the Healthdirect Australia overview of endoscopic sinus surgery and the European Position Paper on Rhinosinusitis and Nasal Polyps 2020. It does not replace personalised medical advice.