Endoscopic Polysinusotomy: Comprehensive Sinus Treatment Without Incisions

When an inflammatory process, pus, or polyps affect not just one, but several paranasal sinuses at once (for example, the maxillary, frontal, and ethmoid labyrinth), conventional treatment with drops or simple rinsing no longer helps. The patient suffers from chronic congestion, postnasal drip, constant headaches, and a complete loss of smell.

To solve this extensive problem, ENT surgeons at St. Luke’s Clinic use endoscopic polysinusotomy (FESS — Functional Endoscopic Sinus Surgery). This advanced operation allows for the cleaning of all affected sinuses in one intervention, restoring their natural ventilation and bringing back the joy of free breathing.

When does an ENT doctor prescribe polysinusotomy?

The decision to perform this operation is made only after a detailed examination and Computed Tomography (CT) of the paranasal sinuses. The main indications for intervention are:

• Polypoid rhinosinusitis: massive growth of polyps (benign formations from the mucous membrane) that completely block the nasal passages and sinuses.
• Chronic purulent pansinusitis or polysinusitis: persistent inflammation and the presence of pus simultaneously in the maxillary, frontal, sphenoid sinuses, and ethmoid cells.
• Fungal lesions (mycetomas): fungal masses affecting several sinuses and unresponsive to medical treatment.
• Presence of multiple cysts in various sinuses, accompanied by pain syndrome.

Advantages of the FESS method at St. Luke’s Clinic

Previously, to clean several sinuses, surgeons had to make incisions on the face (under the lip, near the eyebrow, or eye). This left scars and was accompanied by difficult and painful rehabilitation. FESS technology has forever changed this approach!

• No skin incisions: all surgical manipulations are performed exclusively through the patient’s natural nostrils.
• Video control and microsurgery: the surgeon uses a thin endoscope with an HD camera and special micro-instruments (shaver or microdebrider). The doctor sees every millimeter of the sinus on a large monitor, which allows for precise “shaving” of polyps or widening of sinus ostia without traumatizing healthy mucous membranes.
• Preservation of physiology: the goal of the operation is not just to “clean everything out,” but to restore proper anatomy and natural drainage so that the sinuses can self-clean again.

How is the operation performed and what about anesthesia?

1. Absolute comfort: Polysinusotomy is a major operation, so it is performed exclusively under general anesthesia. For you, it will feel like a normal deep sleep. You will not feel pain or hear any instrument sounds.
2. Course of the operation: The doctor sequentially endoscopically opens all affected sinuses, removes pathological tissues (polyps, pus, fungal masses), and thoroughly rinses them with antiseptics. If necessary, this operation can be combined with straightening of the nasal septum (septoplasty).
3. Completion: Instead of painful gauze tampons, modern hemostatic (blood-stopping) sponges or smooth silicone splints are inserted into the nose, making the postoperative period much easier.

Rehabilitation and Restoration of Breathing

After polysinusotomy, you will stay in a comfortable ward of our hospital (usually 1–3 days) under constant supervision of medical staff.

In the first few days, nasal congestion (due to tissue swelling) and minor bloody discharge will be observed. Full nasal breathing and smell will begin to return after the splints are removed and the swelling subsides (usually within 1-2 weeks).

Important recommendations for the first month after surgery:

• Regularly and correctly rinse your nose with saline solutions (according to your ENT doctor’s instructions).
• Strictly exclude physical exertion, lifting heavy objects, and bending your head down.
• Avoid hot baths, saunas, steam baths, airplane flights, and hot food/drinks (to avoid provoking bleeding).

Get rid of drops, polyps, and headaches! Sign up for expert diagnostics and treatment with ENT surgeons at St. Luke’s Clinic.