Endoscopic sinus surgery

Endoscopic sinus surgery (ESS) is a minimally invasive procedure to open your nasal passages so that your sinuses work better. Also called functional endoscopic sinus surgery (FESS), the procedure is performed to correct sinus problems that haven’t responded well to nasal sprays, medication, or other treatments.  

A surgeon uses an endoscope (thin tube with a light and camera) to perform the procedure through your nostrils, so it doesn’t require any incisions in the skin around your nose. ESS has a lower complication rate than open sinus surgery, and most people recover with minimal discomfort.  

Endoscopic sinus surgery can improve drainage and ease symptoms of frequent sinus infections such as:  

• Congestion 
• Difficulty breathing 
• Drippy nose 
• Headache
• Loss of taste and smell 
• Sinus pain or pressure 
• Sneezing 

The ear, nose, and throat (ENT) specialists at Penn Medicine are well-versed in the latest minimally invasive procedures for all types of sinus and nasal problems. We’re regionally and nationally recognized in the field of rhinology for our work in developing new treatments for rhinosinusitis.  

 As a high-volume program, we routinely evaluate and treat complex sinus conditions with excellent results. Most importantly, we have the treatments you need to breathe easier and enjoy a better quality of life. 

Your health-care provider may recommend endoscopic sinus surgery if you have:  

• Bacterial or fungal sinus infections 
• Chronic sinusitis
• Deviated septum
• Nasal blockages 
• Nasal polyps
• Tumors in the nose or sinuses 

Recovery from endoscopic sinus surgery can take one to two months. You may have mild tenderness and swelling that can be managed with pain medication such as ibuprofen or acetaminophen.  

Your care team will give you detailed instructions about how to rinse your nose out each day with nasal saline spray. Your health-care provider may prescribe antibiotics to prevent infection or corticosteroids (oral or topical) to reduce inflammation. You should avoid strenuous activity and nose-blowing for about a week after your procedure.  

Endoscopic sinus surgery is a relatively safe procedure. Serious complications are uncommon but can include:  

• Cerebrospinal fluid leak 
• Excessive bleeding 
• Infection 
• Injury to the skull base or eye sockets 
• Vision loss due to optic nerve damage  

At Penn Medicine, our ENT doctors have specialized training in areas such as head and neck surgery, skull base surgery, facial plastic and reconstructive surgery, and sleep apnea care. They collaborate with experts in other disciplines such as ophthalmology, neurosurgery, and oncology to ensure you receive comprehensive care.

We also participate in rhinology research and clinical trials to stay at the forefront of the latest procedures and therapies for sinus and nasal conditions. Our depth and breadth of expertise is why providers across the region refer their most complex cases to our team.