Endoscopic Sinus Surgery, revision (Chronic polypoid rhinosinusitis) (anesthesia and hospitalization costs not included)
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Revision endoscopic paranasal sinus surgery is a minimally invasive repeat procedure used for recurrent chronic polypous rhinosinusitis (CPRS). The surgery is performed through the natural nasal passages using an endoscope, allowing detailed visualization of the nasal cavity and sinuses, identification of scar tissue, residual or recurrent polyps, and restoration of sinus drainage pathways.
The procedure aims to remove pathological mucosa and polyps, eliminate adhesions and scar tissue, and widen the anatomical sinus ostia. This restores sinus ventilation and drainage, improves nasal breathing, olfaction, and enhances the effectiveness of subsequent medical therapy.
Indications
• Recurrence of chronic polypous rhinosinusitis after initial FESS
• Residual or newly formed polyps
• Ineffectiveness of medical therapy
• Persistent symptoms: nasal obstruction, purulent discharge, anosmia, recurrent sinusitis
• Postoperative complications: adhesions, ostial obliteration, mucoceles
Procedure / Duration
The surgery is performed through the nostrils, without external incisions, under general anesthesia.
The surgeon removes recurrent polyps and pathological mucosa, eliminates adhesions and scar tissue, and restores anatomical patency of all affected sinuses. Surgical navigation may be used if necessary.
Procedure duration: 60–120 minutes. Soft nasal packing may be applied for 24–48 hours. Hospitalization is usually 1 day; outpatient monitoring 2–3 weeks. Long-term anti-recurrence therapy is recommended: intranasal corticosteroids, nasal irrigations, and, if indicated, immunotherapy.
Contraindications
• Acute upper respiratory infections
• Uncontrolled systemic diseases
• Untreated coagulation disorders
• Exacerbation of chronic conditions
• Allergy to anesthetics or other medications used
Rehabilitation / Limitations
• Hospitalization up to 24 hours
• Nasal packing (if necessary) 24–48 hours
• Recovery period: 2–3 weeks
• Regular nasal irrigations with isotonic solutions
• Continued topical anti-inflammatory therapy
• Limitation of physical activity for 2–3 weeks
• Monitoring of symptoms and regular ENT follow-up
Clinic Advantages
• High-precision endoscopic technique
• Minimally invasive access without external scars
• Use of navigation systems in complex cases
• Minimization of healthy tissue trauma and complication risk
• Rapid recovery and short hospitalization
• Individualized patient approach and comprehensive postoperative supervision
Sources
https://www.ncbi.nlm.nih.gov/books/NBK563202/ https://my.clevelandclinic.org/health/treatments/17478-functional-endoscopic-sinus-surgery
https://www.healthdirect.gov.au/surgery/endoscopic-sinus-surgery
https://www.reginamaria.ro/ponderas/specialitati/orl/chirurgia-endoscopica-functionala-sinusurilor-fess
Preparation:
• Repeat ENT consultation, endoscopic examination, and CT of the paranasal sinuses
• Blood tests (complete blood count, coagulation profile), ECG, anesthetic risk assessment
• Temporary discontinuation of anticoagulants and NSAIDs as advised
• Nasal hygiene and, if indicated, preoperative therapy (intranasal corticosteroids, antibiotics)
• Fasting 6–8 hours prior to surgery (if general anesthesia)
