Another look at functional endoscopic sinus surgery

Functional endoscopic sinus surgery (FESS) has become a popular and important tool in the surgical management of sinusitis. It is not the ultimate answer, however, because factors other than ostiomeatal blockage play a role in pathogenesis. FESS has to be credited for the timely and renewed interest in the treatment of sinusitis. The functional postulate that FESS is based on needs to stand the test of time. The use of endoscopes, on the other hand, has proven its value and versatility in rhinology. The literature may be confusing because the term FESS has been used inappropriately to describe all kinds of sinus surgeries. Computer-assisted technology is developing and could become an additional important surgical tool. The definition and staging of sinusitis continue to evolve but no perfect staging system is available to date. Conventional surgeries are still practiced and need to be taught.