Endoscopic sinus surgery

The cost of this procedure depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant’s outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

Your consultant may recommend endoscopic sinus surgery if you suffer from chronic sinus inflammation or sinusitis that hasn't improved with other treatments like antibiotics and allergy medications. It can also be used to treat nasal polyps.

Endoscopic sinus surgery can help with symptoms such as nasal pain, congestion, poor drainage, difficulty breathing through your nose and loss of sense of smell (anosmia) by treating the following conditions:

• Sinusitis (persistent or chronic sinus infections)
• Nasal polyps
• Sinus and nasal tumours
• Nasal obstruction or blockage

The benefits of endoscopic sinus surgery vary depending on your individual symptoms and diagnosis. Benefits may range from a permanent cure to a reduction in some or all of your symptoms.

Endoscopic sinus surgery is not suitable for everyone, and your consultant will discuss the pros and cons of surgery at your initial consultation.

Benefits of endoscopic sinus surgery may include:

• Reduction in symptoms such as a blocked nose, fullness in your cheeks, frontal headaches, nasal discharge, and post-nasal drip
• Fewer and less severe sinus infections
• Improved drainage of your sinuses
• Makes breathing through your nose easier
• Improved sense of smell
• May reduce symptoms of halitosis (bad breath)
• Improved sleep

At your first consultation, you will be seen by a consultant ENT (ear, nose and throat) or head and neck surgeon. Your consultant will ask you about your symptoms, general health and past medical history. They will perform a physical examination and may arrange for tests including:

• Nasal endoscopy - uses a flexible tube with a camera to examine your nasal passages for abnormalities, infection or inflammation
• Computerised tomography (CT) scan - provides detailed images of your sinuses to see which are affected

How is a diagnosis made?

Your consultant will make a diagnosis based on your symptoms and the results of any tests.

Why is this first consultation so important?

At Circle Health Group, your first appointment is important as it's where your consultant will ask you about your symptoms, perform a physical examination, order any necessary tests, provide a diagnosis, and discuss possible treatments.

Your first consultation is also where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please discuss any questions or concerns with your consultant during your appointment.

At the end of your appointment, your consultant will decide if endoscopic sinus surgery is a suitable treatment for you based on your symptoms, diagnosis, general health and expectations for treatment.

Your consultant will tell you everything you need to do to prepare for your endoscopic sinus surgery. If there's anything you’re not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Your consultant will arrange some pre-operative tests such as a blood test, chest X-ray and ECG to make sure you are fit for surgery.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medications, including over-the-counter medicines or supplements you are taking.

Your consultant may tell you to stop taking some medications like blood thinners for a few days before your operation. This is to reduce the risk of bleeding during and after your surgery.

If you are having a general anaesthetic, you will not be able to eat or drink anything from midnight on the day of your operation. Your healthcare team will advise you about when you can eat and drink before your surgery.

What lifestyle changes can I make before my surgery?

Being as healthy as possible before your surgery can reduce the risk of complications and speed up your recovery.

Before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• Take regular exercise
• If you smoke, you should stop at least four weeks before your surgery and for a month afterwards. Smoking causes increased scar tissue and poor wound healing which may result in your surgery being unsuccessful.
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding.

Endoscopic sinus surgery is usually performed under a general anaesthetic, but in some cases, you may be given a local anaesthetic which means you'll be awake during the surgery but won't feel any pain. Your consultant will discuss the type of anaesthetic to be used before your procedure. Endoscopic sinus surgery usually takes between one and two hours.

During endoscopic sinus surgery:

• Once the anaesthetic has taken effect, your consultant will insert an instrument called an endoscope (a thin tube with a light and a camera at the end) into one of your nostrils
• Your consultant will examine your sinuses and locate the problem
• Specially designed instruments are inserted alongside the endoscope and any blockages such as swollen mucus membranes, scar tissue and nasal polyps are removed, widening the passages from your sinuses to your nose
• If your septum is deviated (crooked), your consultant will straighten your septum and reduce the size of the bony structures inside the sinuses
• When your surgery is complete, you will be taken to the recovery room where you will be monitored closely until the effects of the anaesthetic have worn off.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery or recovery.

After your endoscopic sinus surgery

When you wake up, you may have a dressing in your nostrils to prevent bleeding. This may be uncomfortable, and you will need to breathe through your mouth. The dressing will be removed before you leave hospital.

How many nights will I need to stay in hospital?

Endoscopic sinus surgery is normally performed as a day case, meaning you'll usually go home the same day. Sometimes, you may need to spend one night in hospital after your procedure.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your endoscopic sinus surgery. Please make arrangements for someone to collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your surgery depends on your individual recovery, and the type of job you do. Most people take around a week off work to recover after endoscopic sinus surgery but expect to take at least two weeks off if your job is physically demanding, or you work in a dusty environment.

How soon can I drive?

You should not drive until you can safely control your vehicle and perform an emergency stop. Most people can resume driving two days after endoscopic sinus surgery. Do not drive if you are taking strong painkillers or other medications that may affect your concentration and impair your reaction times.

When will I be back to normal?

Endoscopic sinus surgery is a minimally invasive procedure with a fairly quick recovery time. You can help your recovery go more smoothly by taking things at your own pace and following your consultant's post-operative instructions carefully. Call the hospital if you have any questions or concerns. Most people are fully recovered and able to resume normal activities within two to four weeks.

During your recovery:

• You can expect to have some bloody discharge from your nose for a few days after your endoscopic sinus surgery
• You may have mild pain or pressure in the days following your surgery. Over-the-counter painkillers like paracetamol can help manage any pain or discomfort.
• Your nose will feel congested (blocked) for a few weeks after your endoscopic sinus surgery. This will gradually subside, and your breathing should return to normal after around two to three weeks.
• Your consultant will prescribe a nasal spray or drops for you to use during your recovery. You may also be given antibiotics to reduce the risk of infection.
• You may need to rinse your nose and sinuses with a saltwater solution (saline douche) for the first month after your endoscopic sinus surgery. Your healthcare team will advise you on this. 
• You will probably feel more tired than usual for around the first week after surgery. We advise you to rest at home for a week or two after your endoscopic sinus surgery.
• Your healthcare team will give you a follow-up appointment to check your recovery. This is normally two to four weeks after your surgery.
• Don't blow your nose for at least a week after your surgery
• Avoid straining and heavy lifting for the first two weeks after your surgery
• Do not take aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) or use steroid nasal sprays for two weeks after your procedure

As with all types of surgery, endoscopic sinus surgery carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have. 

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Adverse reactions to the anaesthetic

In addition to the above, possible complications specific to endoscopic sinus surgery include:

• Loss of sense of smell - Some people report losing all or part of their sense of smell after endoscopic sinus surgery
• Adhesions - the formation of scar tissue inside your nose
• Cerebrospinal fluid (CSF) leak - rarely, the bone that separates the brain from the nose may be damaged during surgery resulting in a leak of cerebrospinal fluid (CSF) and a second procedure is required to repair the damage
• Eye damage and vision changes - very rarely, injury to the eye during surgery may result in temporary or permanent double vision or other changes to your vision. Injury to the tear ducts may cause excessive tearing after surgery.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about endoscopic sinus surgery, book your appointment online today or call a member of our team directly on 0808 189 5499.

Content reviewed by Circle in-house team in September 2024. Next review due September 2027.

Endoscopic Sinus Surgery Johns Hopkins Medicine

Endoscopic sinus surgery Health Direct

Endoscopic sinus surgery South Devon Healthcare NHS Foundation Trust

Functional Endoscopic Sinus Surgery (FESS)  University Hospitals Sussex NHS Foundation Trust