Endoscopic Sinus Surgery
Endoscopic sinus surgery (FESS) opens blocked or diseased sinuses using a thin telescope and fine instruments passed through the nostrils, with no external incisions. It treats chronic sinusitis, nasal polyps and recurring sinus infections that have not improved with medication, by clearing disease and widening the natural drainage pathways so the sinuses can ventilate and drain normally.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
The sinuses are air-filled spaces around the nose that normally drain through narrow channels. When these become blocked by inflammation, polyps or anatomical narrowing, mucus builds up and infections recur, causing facial pressure, a blocked or runny nose, reduced sense of smell and repeated sinus infections. When medication — sprays, rinses and courses of treatment — has not controlled the problem, endoscopic sinus surgery can help.
Using an endoscope passed through the nostril, the surgeon sees inside the nose and sinuses on a screen and uses fine instruments to remove polyps and diseased tissue and to widen the natural openings of the sinuses, restoring drainage and airflow. Because everything is done through the nostrils, there are no facial incisions or scars. In some cases a balloon is used to gently widen a sinus opening, or the procedure is combined with straightening a deviated septum.
Surgery improves drainage but is usually part of ongoing care — nasal rinses and medication often continue to keep inflammation under control, particularly for polyps, which can recur. International patients receive a coordinator who arranges the procedure and follow-up, and our ENT specialists can review your CT scan and history remotely to confirm surgery is the right step.
Who is a candidate?
- People with chronic sinusitis not controlled by sprays, rinses and medication
- Patients with nasal polyps causing blockage, facial pressure or loss of smell
- Those with recurring sinus infections affecting daily life
- People whose CT scan shows blocked sinus drainage or anatomical narrowing
- Patients seeking a second opinion on whether sinus surgery is needed
What happens
- 1
Assessment
A nasal endoscopy in clinic and a CT scan of the sinuses confirm the diagnosis and map the anatomy, so surgery can be planned precisely.
- 2
Preparation
You are prepared for general anesthesia, and the surgeon explains the keyhole, through-the-nostril approach and what recovery involves, including nasal care.
- 3
The procedure
Using an endoscope through the nostrils, the surgeon removes polyps and diseased tissue and widens the sinus openings to restore drainage, with no external incisions. A septum repair may be combined if needed.
- 4
Early recovery
Most patients go home the same day or after one night. A blocked, congested nose is normal at first, and saline rinses help cleaning and healing over the following weeks.
- 5
Follow-up and ongoing care
Follow-up checks healing, and medication or rinses often continue to control inflammation, especially with polyps. International patients receive an aftercare plan for use at home.
Benefits
- Relieves chronic sinus symptoms — congestion, facial pressure and recurring infections
- Performed entirely through the nostrils, with no facial incisions or scars
- Restores natural sinus drainage and airflow and can improve sense of smell
- Can be combined with septum correction or balloon widening where appropriate
- Often a day case with a relatively quick return to normal activity
Risks & considerations
- A blocked, congested or crusty nose for a couple of weeks as the lining heals
- Bleeding from the nose, usually minor, in the early recovery period
- Symptoms or polyps can recur, so ongoing medical care is often needed
- Uncommon risks near the eye or skull base, which the surgeon minimizes with image guidance
- The general risks of a general anesthetic
Conditions this treats
Where it is performed
This procedure is performed by our Ear, Nose & Throat Department.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Endoscopic Sinus Surgery — frequently asked questions
It treats chronic sinusitis, nasal polyps and recurring sinus infections that have not improved with medication, by clearing disease and widening the sinuses' natural drainage openings so they can ventilate and drain normally.
No. The surgery is done entirely through the nostrils using a thin telescope and fine instruments, so there are no facial incisions or visible scars.
Surgery usually improves drainage and symptoms significantly, but it is often part of ongoing care. Nasal rinses and medication frequently continue to control inflammation, especially with polyps, which can recur over time.
Yes. Send your CT scan and history and our ENT specialists provide an independent opinion on whether surgery is the right step before you commit to travel.
Endoscopic sinus surgery is often a day case or one night, plus a short local recovery and a follow-up check before flying — your coordinator confirms the plan. We provide a transparent, itemized estimate after reviewing your case rather than a fixed online price.
Related treatments
Considering endoscopic sinus surgery?
Share your reports for a medical second opinion and a transparent, itemized cost estimate — usually within 48 hours.