What does sinus surgery do?
Endoscopic sinus surgery, also called functional endoscopic sinus surgery or FESS, uses a small camera and instruments through the nostrils to open affected sinuses and remove obstructing tissue when needed. It can improve drainage and access for topical treatment. The planned extent depends on the disease and anatomy.
It is different from septoplasty, which addresses the nasal septum. Some patients need both procedures; others do not. The anatomy explorer can help you picture the structures discussed at your appointment.
Further reading: Johns Hopkins Medicine: Endoscopic Sinus Surgery.
Is surgery the right next step?
The decision considers your symptoms, their effect on daily life, examination findings, and previous treatment. Chronic sinusitis should be confirmed before planning surgery. A CT scan and nasal endoscopy help clarify the problem; a scan alone does not make the decision.
The 2025 AAO-HNSF guideline recommends individualized assessment rather than requiring every patient to complete the same medication regimen first. The anticipated benefit of surgery should outweigh nonsurgical care alone, with a shared understanding that ongoing disease management may still be needed.
Further reading: AAO-HNSF: Surgical Management of Chronic Rhinosinusitis, 2025.
Discuss the alternatives.
Depending on the diagnosis, options may include saline irrigation, topical medication, treatment of contributing conditions, or continued observation. Nasal polyps may call for a discussion of biologic treatment as well as surgery. Balloon dilation and in-office procedures address selected problems; they are not interchangeable with every sinus operation.
Use the consultation to ask which symptoms the proposed treatment is expected to help, which may have another cause, and what would happen if you waited.
Where will treatment take place?
Consultations are at 234 East 85th Street, 4th Floor, New York, NY 10028. An office visit does not determine the setting of an operation. The procedure, anesthesia needs, medical history, and complexity all inform whether treatment belongs in an office suite or an operating room.
Bring a list of treatments you have tried, available imaging, and any prior operative reports. If you have already had sinus surgery, see the revision surgery and second-opinion guide. Call the office to confirm insurance participation and the records needed for your visit.
Healing is part of treatment.
Expect a period of congestion and nasal drainage during healing. Your surgeon will give you a specific plan for rinses, medication, follow-up visits, and returning to work or exercise. The schedule varies with the operation and your recovery.
Follow-up may include endoscopic examination and cleaning of healing sinus cavities. Use your own discharge instructions for activity and medication decisions. A general guide cannot replace those instructions.
Further reading: Mount Sinai: Care after Sinus Surgery.
Understand the trade-offs.
Discuss bleeding, infection, persistent symptoms, changes in smell, and the possibility of further treatment. Because the sinuses border the eyes and skull base, rare but serious risks include eye injury and cerebrospinal fluid leak. Ask how your anatomy and medical history affect the risks.
Surgery aims to improve control of sinus disease; it does not guarantee a permanent cure. Make the long-term treatment plan part of the decision.
Further reading: Johns Hopkins Medicine: Endoscopic Sinus Surgery.