Endoscopic Sinus Surgery (ESS) is a modern surgical technique used to treat chronic sinus problems that do not respond to medications. It is a form of endoscopic surgery, meaning it is performed using a small telescope (endoscope) inserted through the nostrils. This allows the surgeon to see and work inside the sinuses without making any external cuts.
This surgery aims to open up blocked sinus pathways, improve drainage, and reduce symptoms such as facial pressure, nasal congestion, runny nose or post-nasal drip, decreased sense of smell and frequent infections.
While surgery can greatly improve symptoms, some patients may still require ongoing medical treatment for allergies or inflammation afterwards.
ESS may be recommended if you have:
Before considering surgery, Dr Phillips will usually try medical therapies such as nasal sprays, saline rinses, antibiotics, and possibly steroids if they haven’t already been tried by your local GP. If symptoms continue, ESS may be the next step.
As with any surgery, there are some risks involved, although serious complications are rare. These may include:
Your surgeon, Dr Phillips, will discuss these risks with you in detail and answer any questions you may have.
Let Dr Phillips know about any medications or supplements you’re taking, especially blood thinners. Some may need to be paused before surgery.
Avoid smoking, as it can delay healing and reduce the success of the procedure.
If you’re having general anaesthesia, do not eat or drink anything for at least 6 hours before surgery. Follow instructions from your anaesthetist or hospital.
If you develop a cold, fever, or infection close to your surgery date, let us know as your surgery may need to be postponed.
Endoscopic sinus surgery is usually performed under general anaesthesia and takes about 1–2 hours, depending on the extent of the sinus disease.
Because the surgery is done through the nose, there are no external cuts and any sutures placed inside the nose are dissolvable.
Most patients go home the same day (day surgery), although some may stay overnight if needed.
Your nose will likely feel blocked or congested for 1–2 weeks after surgery due to swelling or crusting. This temporary nasal obstruction is normal during the early healing phase.
Mild to moderate discomfort or pressure in the nose is common and you will feel quite congested and tired, like having a cold or flu. In most cases this can be managed with regular pain relief such as paracetamol or ibuprofen. Stronger pain relief is provided as necessary.
A small amount of ooze or bleeding is normal for 1 week post op. Significant bleeding is uncommon. If bleeding is heavy or persistent, seek medical attention.
To promote healing and prevent crusting, you’ll be asked to rinse your nose with a saline solution (e.g., FLO or FESS) multiple times a day. Start as directed, in most cases the following morning after surgery.
Contact our clinic or seek urgent medical attention if you experience:
A follow-up appointment will be arranged with Dr Phillips about 1–2 weeks after surgery. During this visit, any crusts or remaining packing may be removed, and healing will be checked.
You may need several follow-up visits to monitor healing and maintain the surgical openings.
No. This is not a cosmetic procedure and does not change the external shape of your nose.
Endoscopic sinus surgery helps improve sinus drainage and function, but it doesn’t cure the underlying cause of chronic sinusitis. You may still need:
• Ongoing nasal sprays or rinses
• Allergy treatment or management
• Monitoring for recurrence of symptoms
Following your surgeon’s advice and sticking to your nasal care routine is essential for long-term success.
Functional endoscopic sinus surgery, like ESS, is a minimally invasive procedure performed through the nostrils using a nasal endoscope. It aims to restore natural sinus drainage by carefully opening blocked sinus pathways and removing diseased tissue when required.
FESS is commonly used for chronic sinus infection (sinusitis), nasal polyps and other sinus symptoms such as nasal obstruction, rhinorrhoea, or post nasal drip that have not improved with medical therapy. This approach aims to restore ventilation and drainage of the functional sinus cavities, allowing mucus to clear more effectively.
FESS is considered the modern approach to endoscopic sinus surgery. Both procedures use similar endoscopic techniques, but FESS focuses on preserving healthy sinus tissues while improving ventilation and drainage of the sinus cavities. The choice of technique depends on your specific sinus condition and CT scan findings.
Studies show many patients experience an improvement in symptoms such as nasal congestion, sinus pressure and recurrent sinus infections after FESS. Outcomes vary depending on factors such as inflammation, allergies, nasal polyps and adherence to postoperative care. Dr Phillips will discuss the likely benefits based on your individual sinus pattern and medical history.
Risks are similar to other forms of endoscopic sinus surgery and may include bleeding, infection, scar tissue formation or ongoing sinus symptoms. Rare complications include a cerebrospinal fluid leak or injury to structures around the eye. Dr Phillips will outline these risks in detail and discuss how they are minimised during surgery.
Most people resume light activity within a few days and return to work within one to two weeks, depending on how they feel and the type of work they do. Nasal congestion, mild discomfort and small amounts of bloody discharge are common in the first week. The sinuses continue to heal over several weeks, so ongoing care, such as saline rinses, is important.
Discomfort after surgery is generally mild to moderate. Many patients describe it as similar to having a heavy cold. Pain is usually managed with standard medications, and Dr Phillips will provide guidance on how to reduce pressure, congestion and discomfort during the early recovery period.
Many patients with chronic sinusitis notice a reduced or fluctuating sense of smell due to ongoing inflammation or blocked sinus pathways. Endoscopic sinus surgery may help improve airflow and allow the sinuses to function more normally, which can support improvement in smell over time. Results vary from person to person and depend on factors such as underlying inflammation, allergies and the presence of nasal polyps. Dr Phillips will discuss what to expect based on your individual condition.
Yes. Nasal polyps can be removed during endoscopic sinus surgery to improve airflow and sinus drainage. Some individuals may require ongoing treatment after surgery, as polyps can recur due to underlying inflammation or allergies.
Not everyone requires antibiotics. They may be prescribed if there is evidence of infection or significant inflammation. Most postoperative care focuses on nasal rinses, topical nasal steroid sprays (when appropriate) and follow-up appointments to ensure the sinuses heal as expected.
Healing can be affected by persistent inflammation, allergies, nasal polyps, infection or the formation of scar tissue. Avoiding nose blowing, completing saline rinses as directed and attending scheduled follow-up appointments all help support healing and reduce the chance of problems in the early weeks after surgery.
If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.
To book with Dr Phillips, you’ll need a referral from your GP or specialist. Questions? Call our team — we’re happy to help.
