FUNCTIONAL
ENDOSCOPIC SINUS
SURGERY
A clinical abstract
NASAL POLYPS
Nasal polyps are teardrop-
shaped, noncancerous
growths on the lining of
your nasal passages or
sinuses.
Larger nasal polyps can
block your nasal passages or
sinuses and cause breathing
difficulties, a loss of your
sense of smell, frequent
sinus infections and other
problems.
NASAL POLYPS
Although nasal polyps can affect anyone, they're
more common in adults, particularly those with
asthma, frequent sinus infections and allergies.
Children with cystic fibrosis often develop nasal
polyps.
Medications can often lessen the size of nasal
polyps or eliminate them, but surgery is
sometimes necessary to remove them. Even after
successful treatments, nasal polyps often return.
SIGNS AND SYMPTOMS
A runny nose
Persistent stuffiness
Postnasal drip
Decreased or no sense of
smell
Loss of sense of taste
Facial pain or headache
Snoring
Itching around your eyes
CAUSES
Same with
PATHOPHYSIOLOGY
PATHOPHYSIOLOGY OF NASAL
POLYPS
Pathophysio
logy of Nas
al Polyps
Definition of surgery
• Functional endoscopic
sinus surgery (FESS) is
a minimally invasive
surgical procedure that
opens up sinus air cells
and sinus ostia
(openings) with an
endoscope.
PURPOSE OF FESS
• The purpose of
FESS is to
restore normal
drainage of the
sinuses.
How is fess is done?
FESS SURGERY
Most FESS operations are
done under general anaesthetic
(fully asleep) in the operating
theatre.
The anaesthetist usually sends
you to sleep by injection. You
will be asleep within a few
seconds. The anaesthetist then
puts a plastic tube through
your mouth into the trachea
(windpipe) so that you can
breathe during the operation.
FESS SURGERY
Normally there is no external cut, the surgery is
done through the nostrils.
A powerful headlight and angled telescopes to
see around corners are used.
Using specially designed fine bone - cutting
instruments, and powered suction debriders
when appropriate, the sinus openings will be
enlarged and anything blocking the sinuses, such
as swollen mucosa or polyps, will be removed.
FESS SURGERY
Other procedures such as
septoplasty and LASER
vapourization of inferior
turbinates are often done at
the same time as FESS.
If you need stitches, they
will be internal and self-
dissolving.
Most FESS operations
take less than an hour to
do.
FESS SURGERY
• At the end of the operation
it is usual to have a pack
(sponge dressing) in each
nostril to soak up any
blood. This is kept in for a
few hours. If you have an
afternoon operation it will
normally stay in overnight,
if you have a morning
operation it may be
removed in the afternoon.
NURSING MANAGEMENT
Pre-Operative Nursing Management
Consent.
Interview patient regarding general health
history.
Attach Identity bracelet at wrist.
NPO for 6 hours before surgery
Remove dentures, nail polish, jewelry.
Shave the moustache if there is any.
NURSING MANAGEMENT
Intra-Operative Nursing Management
Prepare all the things needed for the surgery.
Draping.
Assist the surgeon, resident and intern by
giving the instruments to them.
Complete count of instruments, OS, etc.
Safety of the patient.
AFTERCARE.
NURSING MANAGEMENT
POST-Operative Nursing Management
Transfer to PACU.
Provide Warmer.
Monitor Vital Signs q15 for first 2 hours.
Change the pack in the nose if it is
already soaked with blood.
Pain medications.
SOURCES
http://www.entkent.com/FESS.html
http://www.aafp.org/afp/980901ap/slack.html
http://www.surgeryencyclopedia.com/Ce-
Fi/Endoscopic-Sinus-Surgery.html
http://www.bhj.org/journal/1999_4104_oct99/sp_6
71.htm
http://emedicine.medscape.com/article/994274-
overview
http://mayoclinic.com
