A/Prof Luke Tan
Consultant ENT, Head & Neck Surgeon
FAMS (ORL), FRCS (England), Head & Neck Surgery (Texas, USA)
Nasal and sinus endoscopic surgery is a minimally invasive procedure used to treat selected nasal and sinus conditions. It may help relieve persistent symptoms such as nasal blockage, recurrent sinus infections and facial pressure in patients whose symptoms have not responded adequately to medical treatment.
A/Prof Luke Tan is an ENT, Head & Neck Surgeon with experience in the assessment and surgical management of nasal and sinus conditions. He consults patients at Mount Elizabeth Medical Centre and Mount Alvernia Hospital.
What Is Endoscopic Sinus Surgery?
Endoscopic sinus surgery, also known as functional endoscopic sinus surgery (FESS), is a minimally invasive procedure used to restore normal sinus drainage and ventilation in patients with selected nasal and sinus conditions.
The procedure is performed through the nostrils using an endoscope, a thin tube fitted with a light and camera, together with specialised surgical instruments. This allows the surgeon to access the nasal passages and sinuses without making external incisions.
By opening blocked sinus drainage pathways while preserving as much healthy tissue as possible, endoscopic sinus surgery aims to restore normal sinus function, improve airflow and support the long-term management of chronic sinus disease.
When Is Endoscopic Sinus Surgery Recommended?
Endoscopic sinus surgery may be considered when sinus symptoms persist despite appropriate medical treatment, or when conditions such as nasal polyps, recurrent sinus infections or selected nasal and sinus growths require surgical management.
Surgery is not appropriate for everyone with sinus symptoms. Before recommending surgery, an ENT specialist will confirm the underlying diagnosis and consider factors such as the severity of your symptoms, your response to previous treatment and your overall health.
Conditions that may be treated with endoscopic sinus surgery include:
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Chronic or Recurrent Sinusitis
Persistent inflammation or repeated sinus infections can cause ongoing nasal blockage, facial pressure, pain and nasal discharge. Surgery helps restore sinus drainage by opening blocked pathways and may be recommended when symptoms persist despite appropriate medical treatment.
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Nasal Polyps
These soft, non-cancerous growths can block the nasal passages and sinuses, leading to nasal obstruction, a reduced sense of smell and recurrent infections. Endoscopic sinus surgery allows targeted removal of polyps while preserving surrounding healthy tissue.
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Nasal Obstruction or Blockage
Structural problems such as a deviated septum, as well as persistent swelling within the nasal passages, can make breathing through the nose difficult. Endoscopic techniques may be used alongside procedures such as septoplasty to improve airflow where appropriate.
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Sinus and Nasal Tumours
For selected benign or malignant growths, endoscopic techniques may be used to obtain a biopsy or remove the tumour while minimising disruption to surrounding structures. The most appropriate surgical approach depends on the type, size and location of the growth.
When Should You See a Sinus Specialist?
You should consider seeing a sinus specialist if you have persistent or recurrent symptoms such as:
- A blocked nose or difficulty breathing through the nose
- Facial pressure or pain around the cheeks, eyes or forehead
- Thick nasal discharge or postnasal drip
- A reduced sense of smell or taste
- Recurrent sinus infections
- A feeling of pressure or fullness around the face
- Symptoms that persist despite appropriate medical treatment
These symptoms do not always mean surgery is required. An ENT assessment can help identify whether the underlying cause is chronic sinusitis, nasal polyps, allergies, structural narrowing, migraine-related facial pain or another condition, allowing the most appropriate treatment to be recommended.
Living with ongoing nasal blockage, facial pressure or frequent sinus infections does not have to become your normal. A/Prof Luke Tan can help determine the underlying cause and whether further treatment is appropriate.
Schedule a ConsultationWhat to Expect Before, During and After Sinus Surgery
Sinus surgery involves more than the procedure itself. Assessment before surgery, preparation, the operation and postoperative care all play an important role in supporting a safe recovery and achieving the intended treatment outcome.
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Diagnosis and Assessment
Before recommending sinus surgery, your ENT specialist will review your symptoms, medical history, previous treatments, allergy history and any prior sinus procedures.
A nasal endoscopy may be performed during your consultation to examine the nasal passages for swelling, polyps, discharge or structural narrowing.
A CT scan may be recommended to assess the anatomy of the sinuses and the extent of disease when more detailed evaluation is required. Together with your examination findings, this helps confirm the diagnosis, determine whether surgery is appropriate and guide surgical planning.
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Preparing for Surgery
Before surgery, your specialist will provide instructions tailored to your procedure and overall health. Preparation commonly includes:
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Preoperative Assessment
You may require blood tests or other investigations to confirm you are medically fit for surgery and anaesthesia.
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Medications
Tell your doctor about all medications and supplements you are taking. Some may need to be stopped or adjusted before surgery.
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Fasting
If you are having a general anaesthetic, you will need to avoid food and drink for the period advised before your procedure.
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Smoking Cessation
Smoking increases the risk of complications and may delay healing. Stopping several weeks before surgery is strongly recommended.
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Arranging Transport Home
As you will not be able to drive after a general anaesthetic, arrange for someone to accompany you home.
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The Procedure
Endoscopic sinus surgery is usually performed under general anaesthesia. The duration of surgery depends on the condition being treated and the extent of the procedure.
Most procedures take between one and three hours. Most patients return home on the same day, although an overnight stay may occasionally be recommended for more extensive procedures or where closer monitoring is required.
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Recovery and Postoperative Care
After surgery, you will spend time in a monitored recovery area while the effects of the anaesthetic wear off. Before you go home, your care team will provide instructions on medications, nasal care and activity restrictions to support your recovery.
During recovery, your specialist may recommend:
- Nasal saline spray
- Sinus irrigation
- Activity restrictions
- Medications
- Follow-up appointments
What Are the Benefits of Endoscopic Sinus Surgery?
The aim of endoscopic sinus surgery is to restore normal sinus function and relieve symptoms that have not responded adequately to medical treatment. While outcomes vary depending on the underlying condition and extent of disease, many patients experience meaningful improvements following recovery.
Relief of Sinus Pressure
By improving sinus drainage, the procedure may help relieve ongoing facial pressure and congestion associated with chronic sinus disease.
Reduced Frequency of Sinus Infections
Restoring normal sinus drainage may help reduce the frequency of recurrent sinus infections in suitable patients.
Improved Nasal Breathing
Restoring airflow through the nasal passages may make breathing through the nose easier and more comfortable.
Better Sleep and Quality of Life
For some patients, improved nasal breathing may contribute to better sleep quality and make everyday activities more comfortable.
No External Incisions
As the procedure is performed through the nostrils, external incisions are generally not required. Recovery varies between individuals, but many patients return to normal daily activities sooner than they would after open surgery.
Seek relief from persistent sinus symptoms with expert assessment and treatment by A/Prof Luke Tan. From your first consultation to recovery, every stage of your care is tailored to achieving the best possible outcome.
Schedule a ConsultationRisks and Possible Complications of Endoscopic Sinus Surgery
Endoscopic sinus surgery is generally a safe procedure, but like all surgery, it carries some risks. Your surgeon will explain the potential complications, how they are minimised and what they may mean for your recovery before you decide whether to proceed.
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Changes in Sense of Smell
Temporary alteration or reduction in smell may occur due to postoperative swelling or healing changes. This typically improves as inflammation settles.
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Bleeding
Light nasal bleeding is common after surgery. Persistent or heavy bleeding is uncommon and should be assessed by a doctor.
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Infection
Although surgery aims to reduce recurrent sinus infections, infection can still occur during the healing phase and may require medical treatment.
Most patients recover without significant complications. Following your postoperative instructions and attending scheduled follow-up appointments helps support healing and allows any concerns to be identified early.
Find Out Whether Endoscopic Sinus Surgery Is Right for You
Persistent nasal blockage, recurrent sinus infections or ongoing facial pressure do not always mean surgery is necessary. At Luke Tan ENT-Head & Neck-Sinus and Thyroid Surgery Centre, treatment begins with a comprehensive assessment to identify the underlying cause of your symptoms and determine whether medical treatment, continued monitoring or endoscopic sinus surgery is the most appropriate option.
A/Prof Luke Tan provides assessment and surgical management for a wide range of nasal and sinus conditions, recommending surgery only when it is clinically appropriate. Arrange a consultation to discuss your symptoms and explore the treatment options available.
Frequently Asked Questions About Our ENT Clinic
When Should Revision Functional Endoscopic Sinus Surgery Be Considered?
Revision functional endoscopic sinus surgery may be considered when symptoms persist or recur after previous sinus surgery. Common reasons include scarring, ongoing inflammation, recurrent sinus infections, or regrowth of nasal polyps. An ENT specialist will assess your symptoms, imaging findings and surgical history before advising whether revision surgery is appropriate.
How Does Functional Endoscopic Sinus Surgery Differ From Traditional Sinus Surgery?
Functional endoscopic sinus surgery is a minimally invasive approach that uses an endoscope inserted through the nostrils to access and treat the sinuses. Unlike traditional sinus surgery, it does not require external incisions. This approach is designed to minimise disruption to surrounding tissues and avoid visible scarring. Recovery experiences vary, but many patients find recovery more manageable compared with open surgical techniques.
How Long Does Recovery Take After Functional Endoscopic Sinus Surgery?
Recovery time varies depending on the extent of surgery, individual healing, and daily activity demands. Some patients may feel well enough to return to work or school within about one week, particularly for non-physical roles. Light daily activities are often resumed within the first one to two weeks, while internal healing can continue over several weeks. Your ENT specialist will provide personalised advice based on your procedure and recovery progress.
Will endoscopic sinus surgery cure chronic sinusitis permanently?
Endoscopic sinus surgery improves sinus drainage and ventilation, but it does not cure the underlying causes of chronic sinusitis. Some patients may still require ongoing medical treatment, such as saline irrigation, nasal sprays or medication, to help control inflammation and reduce the risk of future flare-ups.
Will I have nasal packing after endoscopic sinus surgery?
Not always. Whether nasal packing is used depends on the extent of surgery performed and your surgeon's preference. Many patients either do not require nasal packing or have absorbable materials that dissolve naturally during healing.
When can I return to work after endoscopic sinus surgery?
The timing depends on the extent of your procedure and the type of work you do. Many people with office-based jobs return within about one week, while those whose work involves heavy physical activity may require a longer recovery period. Your surgeon will advise you based on your progress.
