Sinus Surgery (FESS)

Goals: Improve sinus drainage, treat chronic sinusitis, remove polyps, possibly help with headaches, and restore normal breathing and smell.

Risks: Bleeding, infection, scarring leading to recurrent sinus obstruction requiring revision surgery; rare risks include CSF leak, orbital injury, or changes in smell.

Typical Length: 30-90 min, depending on extent of disease and number of sinuses to be addressed.

Postoperative Care:

Nasal Packing: If placed, will be removed at your first follow-up (typically within 1 week). Breathing will be difficult until then.

Nasal Stents: If placed, typically are removed after 2 weeks.

Nasal Saline Irrigations: Begin after first debridement. Use a sinus rinse bottle with saline packets 2-3 times daily. This is essential for healing — continue for at least 4-6 weeks.

Avoid Nose Blowing: Do not blow your nose for 4 weeks. Sneeze with your mouth open.

Activity Restrictions: No bending, lifting (>10 lbs or a jug of milk), or straining for 2 weeks. This includes exercise (i.e. anything that’s intended to maintain or build physical fitness), sexual activity, housework (i.e. vacuuming), and other strenuous activity.

Some bloody nasal drainage is normal for the first 1-2 weeks — use drip pads as needed.

Call your doctor if: You soak more than 4 pads in an hour, experience clear watery drainage from the

nose, worsening headache, vision changes, fever, or foul-smelling drainage.

Facial pressure, congestion, and mild headache are normal — typically resolves in 1-2 weeks.

If you have sleep apnea and wear a CPAP, you will need to hold off on wearing it for 4 weeks after surgery.

Typical Recovery Timeline

• Day 1-3: The most uncomfortable period with congestion, pressure, and fatigue. Rest with head elevated. Many can switch to plain Tylenol by Day 3.

• Days 3-7: Congestion persists but discomfort improves.

• Week 1: First follow-up for debridement (cleaning) of the sinuses.

• Week 2: Packing/stents removed if stents present.

• Weeks 2-3: Congestion gradually improves. Continue saline irrigations diligently. Ok to resume light activity.

• Week 3-4: Most feel close to or fully back to 100%. May resume exercise and physical activity.

Avoid swimming or submerging head in water.

• Week 6: Sinuses typically well-healed. Most restrictions lifted.

• 3 Months: Full mucosal healing. Final results of surgery can be assessed.

Typical Follow-Up

• Week 1 – first debridement (if no stent placed)

• Week 2 – stent removal (if placed) and first debridement.

• Week 3 – second debridement if needed

• Week 6, 3 months, and as needed thereafter.

• Additional visits for concerns or complications, or for polyp surveillance