# Endoscopic Sinus Surgery (FESS)

> Functional endoscopic sinus surgery (FESS) for chronic sinusitis and polyps by Op. Dr. Cenk Teker, ENT surgeon in Istanbul. No external incisions.

Source: https://www.drcenkteker.com/en/procedures/sinus-surgery-fess/  
Updated: 2026-10-29

Nose & sinus

Reopening the drainage of the sinuses through the nostrils, with no incision on the face.

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Performed by Op. Dr. Cenk Teker

Operation time 1–2 hours

Anaesthesia General

Hospital stay Day case or 1 night

Back to work 5–7 days

Final result 6–12 weeks

The sinuses are air-filled spaces in the bones of the face, connected to the nose by small openings. When those openings block, mucus is trapped, the lining swells and infection follows. Chronic sinusitis is sinusitis that lasts more than twelve weeks despite treatment: facial pressure, congestion, discharge down the throat, a lost sense of smell and a general feeling of never being quite well.

Functional endoscopic sinus surgery, known as FESS, restores the drainage. It is called functional because the aim is to reopen the natural pathways of the sinuses and leave the sinuses intact, so they can look after themselves again. It is called endoscopic because the whole operation is done through the nostrils with a thin telescope, watched on a screen, with nothing cut on the outside of the face.

## When surgery is considered

Most sinusitis is treated with medication first: saline rinses, steroid sprays, courses of antibiotics or oral steroids. Dr. Teker recommends surgery when these have been given a fair trial and symptoms persist, when a CT scan shows fixed blockage or polyps, or when infections keep returning. Nasal polyps, soft growths of inflamed lining, are the most common reason; they block the nose and the sinuses and often take the sense of smell with them.

## What happens in the operation

Guided by the CT scan, Dr. Teker widens the openings of the affected sinuses in turn: the maxillary sinuses in the cheeks, the ethmoid cells between the eyes, the frontal sinuses in the forehead and the sphenoid at the back. Polyps and diseased lining are removed with a microdebrider designed to spare healthy tissue. A [deviated septum](https://www.drcenkteker.com/en/procedures/septoplasty-deviation-surgery/) or enlarged turbinates are corrected at the same time if they contribute to the blockage. The operation takes one to two hours and most patients go home the same day.

## After surgery

The first week is about keeping the nose clean: saline rinses several times a day, and a visit around day five to seven to remove crusts. Congestion usually clears over two to three weeks. A sense of smell lost to polyps or blockage often improves once the sinus disease is treated, though not in every patient and not always for good. Because the sinuses are now open, steroid sprays and rinses reach where they could not before, which is why rinses and sprays continue after surgery.

## Sinuses and septum together

Sinus, septum and nose are one system, and Dr. Teker treats them as one. Patients who come for [rhinoplasty](https://www.drcenkteker.com/en/procedures/rhinoplasty/) and turn out to have sinus disease, or who come for sinusitis and have a deviated septum, are treated for both in a single operation whenever that is sensible.

## Is it right for you?

- You have had facial pressure, congestion, thick discharge or loss of smell for more than 12 weeks.
- Antibiotics, steroid sprays and rinses have not controlled the symptoms.
- A CT scan shows blocked sinuses or nasal polyps.
- You get sinus infections several times a year.
- You have a fungal sinus infection or a mucocele that needs to be cleared.

## How the operation is done

1. CT scan and endoscopy A CT scan of the sinuses maps exactly which ones are blocked. Endoscopy at the practice shows polyps and the state of the lining.
2. Endoscopic access A thin telescope goes in through the nostril. Everything is done under magnification on a screen; nothing is cut on the outside.
3. Opening the drainage pathways The natural openings of the maxillary, ethmoid, frontal and sphenoid sinuses are widened as needed, so that mucus can drain and sprays can reach inside.
4. Removing polyps and diseased tissue Polyps and irreversibly thickened lining are removed with a microdebrider designed to preserve healthy lining.
5. Septum and turbinates A deviated septum or enlarged turbinates that contribute to the blockage are corrected in the same operation.
6. Closing Dissolvable dressings may be placed in the sinuses. Heavy packing is rarely needed.

## Recovery, step by step

1. Day 1 Blocked nose and mild facial pressure; some blood-stained discharge is normal. Most patients go home the same day.
2. Week 1 Saline rinses several times a day. A first cleaning visit removes crusts. The sense of smell may begin to improve, though not in every patient.
3. Weeks 2–4 Congestion usually clears and breathing opens. You can return to work after the first week and to exercise after two.
4. Week 6 The lining has largely healed. Sprays and rinses continue to keep the sinuses open.
5. Month 3 Final result. Long-term care with sprays and rinses helps prevent recurrence, especially of polyps.

### A note on risks

Complications of endoscopic sinus surgery are rare, but the operation is not without risk. Bleeding in the first days, infection and anaesthetic reactions can occur. Because the sinuses lie next to the eye and the base of the skull, serious injuries to these structures are possible; they are very rare, and CT planning is used to reduce the risk. Polyps can grow back over years, particularly with asthma or aspirin sensitivity, so continued medical care after surgery matters. The effect on the sense of smell is hard to predict: it may improve, stay the same or occasionally get worse.

In every surgical or interventional procedure, results may vary from person to person. Please obtain a detailed opinion from your physician before any procedure.

## Questions patients ask

**Will there be any scars or bruising on my face?**

Usually not. The whole operation is done through the nostrils with an endoscope. There are no external incisions and normally no bruising.

**Do I need packing?**

Rarely. Dr. Teker uses dissolvable dressings where needed, which spare you the discomfort of packing removal.

**Will my sense of smell come back?**

When smell was lost because of polyps or blockage, it often improves once the sinus disease is treated. Removing the polyps is not always enough on its own: anti-inflammatory treatment such as steroid sprays has to continue after surgery, and the improvement does not always last. It cannot be promised, because the result depends on the lining and the nerve.

**Can the sinusitis come back?**

Surgery opens the drainage pathways; it does not change the underlying tendency of the lining to inflame. Continued rinses and sprays help to keep the sinuses healthy and lower the chance of recurrence.

Travelling from abroad? How long to stay in Istanbul, the consultation in person and follow-up after you fly home: [International patients](https://www.drcenkteker.com/en/international-patients/)

## References

1. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, et al. Clinical Practice Guideline (Update): Adult Sinusitis. Otolaryngology – Head and Neck Surgery. 2015;152(S2). [doi:10.1177/0194599815572097](https://doi.org/10.1177/0194599815572097).
2. Fokkens W, Lund V, Hopkins C, Hellings P, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020:1‑464. [doi:10.4193/Rhin20.600](https://doi.org/10.4193/Rhin20.600).

Medically reviewed by Op. Dr. Cenk Teker, 26 October 2026

## Articles on this subject

[Endoscopic Sinus Surgery (FESS) · 6 min read Chronic sinusitis: when is surgery considered? What chronic sinusitis is, how it differs from a cold, the first treatments, how the nose is examined, and when endoscopic sinus surgery (FESS) is considered. Read more](https://www.drcenkteker.com/en/blog/chronic-sinusitis-when-is-surgery-considered/)

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## Talk it through with Dr. Teker

Write on WhatsApp or call to request an appointment. Consultations take place at the practice in Bakırköy.

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