Sinus surgery may be considered when chronic sinusitis causes persistent nasal blockage, facial pressure, mucus, loss of smell or recurrent infections that do not improve enough with medical treatment. For some patients, functional endoscopic sinus surgery, also known as FESS, can help open the sinus drainage pathways and treat inflammation, polyps or chronic sinus disease.
For international patients looking for private ENT surgery in Spain, understanding when sinus surgery may be recommended can help them decide whether to request a specialist assessment. Ribera Care International supports patients before travelling by helping coordinate case review, medical documentation and treatment planning with ENT specialists in Spain.
This guide is designed to help international patients understand chronic sinusitis, FESS surgery and how Ribera Care International can support assessment and treatment planning in Spain.
Quick answer: FESS, or functional endoscopic sinus surgery, may be recommended for chronic sinusitis when symptoms persist despite appropriate medical treatment or when nasal polyps, blocked sinus openings or recurrent sinus infections affect quality of life.
The decision depends on symptoms, nasal endoscopy, imaging tests, previous treatment and the ENT specialist’s assessment.
What is chronic sinusitis?
Chronic sinusitis is long-lasting inflammation of the sinuses that can cause nasal blockage, facial pressure, mucus problems and reduced sense of smell. The sinuses are air-filled spaces around the nose and eyes, and they normally drain through small openings inside the nose.
When the sinus lining becomes inflamed, swollen or blocked, mucus may not drain properly. This can lead to persistent symptoms, repeated infections or ongoing discomfort. Chronic sinusitis can affect sleep, breathing, work performance, exercise tolerance and general quality of life.
Some patients have chronic sinusitis with nasal polyps, while others have chronic sinusitis without polyps. The treatment plan can be different depending on the type of disease, severity of symptoms and findings on examination or imaging.
What symptoms may suggest chronic sinusitis?
Chronic sinusitis can cause symptoms that last for weeks or months and may return repeatedly. Patients often describe blocked breathing through the nose, pressure around the cheeks or forehead, thick mucus, postnasal drip and reduced smell.
Symptoms can overlap with allergies, nasal obstruction, migraine, dental problems or a deviated septum, so specialist assessment is important before deciding whether surgery is appropriate.
Blocked nose
Persistent nasal obstruction can make breathing, sleeping and physical activity more difficult.
Facial pressure
Some patients feel pressure or fullness around the cheeks, forehead, eyes or upper teeth.
Reduced smell
Inflammation or nasal polyps can reduce the sense of smell and sometimes affect taste.
When is sinus surgery considered?
Sinus surgery may be considered when chronic sinusitis continues to affect quality of life despite appropriate medical treatment. Before recommending surgery, the ENT specialist should confirm the diagnosis and assess symptoms, disease characteristics, previous treatment and the patient’s overall health.
Medical treatment may include nasal saline rinses, nasal corticosteroid sprays, treatment for allergies, medication for inflammation or other therapies depending on the case. Surgery is not usually the first step for every patient, but it may be appropriate when symptoms persist or when anatomy, polyps or blocked sinus drainage contribute to the problem.
Important: Sinus surgery should be based on a confirmed diagnosis, not only on nasal congestion.
A specialist assessment can help distinguish chronic sinusitis from allergies, nasal obstruction, headaches or other causes of facial discomfort.
What is FESS surgery?
FESS stands for functional endoscopic sinus surgery. It is a minimally invasive ENT procedure performed through the nostrils using an endoscope, which allows the surgeon to see inside the nose and sinus drainage pathways without external facial incisions.
The aim of FESS is to improve sinus drainage and ventilation by opening blocked sinus pathways, removing diseased tissue when needed and treating nasal polyps or chronic inflammation in selected cases. The exact surgical plan depends on which sinuses are affected and what the specialist finds on examination and imaging.
FESS does not mean the same operation for every patient. Some procedures are limited to one area, while others may involve several sinuses or nasal polyps. Ribera’s procedure list includes both unilateral sinus surgery for chronic sinusitis and bilateral endoscopic sinus surgery for polyposis, so the treatment plan should be personalized to the patient’s diagnosis.
FESS vs septoplasty: what is the difference?
FESS and septoplasty are different ENT procedures, although they may sometimes be discussed together when a patient has more than one cause of nasal obstruction. FESS treats sinus drainage pathways, while septoplasty corrects a deviated nasal septum that blocks airflow through the nose.
A patient with chronic sinusitis may need FESS if the main problem is sinus inflammation, blocked sinus openings or nasal polyps. A patient with a deviated septum may need septoplasty if the main problem is structural nasal obstruction.
Some patients may have both issues. In these cases, the ENT specialist will explain whether one procedure or a combined surgical plan is more appropriate. Patients can also read more about septoplasty surgery.
| Procedure | Main purpose | When it may be considered |
|---|---|---|
| FESS | Opens sinus drainage pathways and treats chronic sinus disease. | Chronic sinusitis, nasal polyps or recurrent sinus infections in selected patients. |
| Septoplasty | Straightens the nasal septum to improve nasal airflow. | Nasal obstruction caused by a deviated septum. |
| Turbinate reduction | Reduces enlarged turbinates inside the nose. | Nasal blockage related to enlarged turbinates, often assessed with other causes. |
How is chronic sinusitis diagnosed before surgery?
Chronic sinusitis is diagnosed through symptoms, ENT examination and, when needed, nasal endoscopy or imaging tests. The specialist will ask about nasal blockage, mucus, facial pressure, smell, allergy history, previous medication and how symptoms affect daily life.
Nasal endoscopy allows the ENT specialist to look inside the nose and assess inflammation, polyps, mucus, septal deviation or other anatomical factors. CT imaging may be requested to evaluate the sinuses and plan surgery if needed.
For international patients, sharing previous ENT reports, CT scans, allergy tests or medication history before travelling can help the team understand the case and decide what additional assessment may be needed in Spain.
What happens during sinus surgery?
During FESS, the surgeon uses a small endoscope and surgical instruments through the nostrils to access the nasal cavity and sinus openings. The goal is to open blocked areas, improve drainage and remove diseased tissue or polyps when clinically indicated.
The operation is planned according to the patient’s anatomy and disease pattern. Some patients need limited surgery on one side, while others need a more extensive procedure involving several sinuses.
The medical team will explain the planned technique, anesthesia, hospital pathway, postoperative care and follow-up before surgery. The patient should also understand what symptoms the surgery is expected to improve and what ongoing medical treatment may still be needed after the operation.
Is sinus surgery painful?
Sinus surgery is performed with anesthesia, so patients should not feel pain during the procedure. After surgery, patients may feel nasal blockage, pressure, mild discomfort, tiredness or blood-stained mucus during the first days.
Recovery experience varies depending on the extent of surgery, whether nasal polyps were treated, the patient’s general health and postoperative care. The ENT team will explain how to clean the nose, use prescribed medication and recognize symptoms that need medical attention.
Recovery after FESS surgery
Recovery after FESS surgery depends on the extent of the procedure and the patient’s healing process. Many patients need a period of rest, nasal care and follow-up after surgery to monitor healing and remove crusting or secretions if needed.
Patients may be advised to avoid heavy lifting, intense exercise, nose blowing, dusty environments and swimming during the early recovery period. Saline rinses or prescribed nasal medication may be recommended as part of postoperative care.
| Recovery aspect | What patients should know |
|---|---|
| First days | Nasal blockage, mild bleeding or blood-stained mucus may occur after surgery. |
| Nasal care | The ENT team may recommend saline rinses, sprays or medication to support healing. |
| Work and activity | Return to normal activities depends on the extent of surgery and medical advice. |
| Follow-up | Follow-up is important to assess healing, symptoms and ongoing sinus care. |
Will FESS cure chronic sinusitis?
FESS can improve sinus drainage and help control symptoms in selected patients, but it does not always remove the underlying tendency to inflammation. Some patients may still need nasal sprays, saline rinses, allergy management or long-term ENT follow-up after surgery.
This is especially relevant for patients with nasal polyps, asthma, allergy, aspirin-exacerbated respiratory disease or recurrent inflammatory disease. The specialist will explain whether the goal is symptom improvement, better drainage, reduced infections, improved smell or easier long-term disease control.
Planning sinus surgery in Spain with Ribera Care International
International patients can send their medical reports, imaging tests and previous diagnosis before travelling. Ribera Care International helps coordinate case review, ENT specialist assessment, hospital planning and the next steps for treatment in Spain.
This is particularly useful for patients who have been living with chronic sinusitis for months or years and want to understand whether private sinus surgery in Spain may be appropriate. The team can help patients prepare the right documents, understand the expected pathway and plan their visit with more clarity.
Request an ENT case review
Send us your ENT reports, CT scan results or previous diagnosis. Ribera Care International will help coordinate your case review and guide you through the next steps for sinus surgery assessment in Spain.
What documents should international patients send?
International patients should send medical documents that help the ENT specialist understand their diagnosis, previous treatment and current symptoms. Complete documentation can make the case review more efficient before travelling to Spain.
Useful documents may include:
- ENT report or diagnosis of chronic sinusitis.
- CT scan of the sinuses, if available.
- Nasal endoscopy report, if available.
- Information about nasal polyps, allergies or asthma.
- List of medications already tried, including sprays, rinses, antibiotics or corticosteroids.
- Previous sinus, septoplasty or nasal surgery reports.
- Description of symptoms and how long they have been present.
- Preferred travel dates, if already known.
Patients preparing for treatment abroad can also read this guide: what medical documents do you need before travelling to Spain for surgery?
Why choose Ribera Care International for sinus surgery in Spain?
Ribera Care International supports international patients who need private medical assessment, hospital coordination and treatment planning in Spain. For sinus surgery, this means helping patients connect with ENT specialists, prepare medical documents and understand the next steps before travelling.
ENT case review
Patients can send reports and imaging before travelling so the case can be assessed by the appropriate team.
Hospital coordination
The international team helps coordinate appointments, hospital planning and communication during the process.
Personalized pathway
The treatment plan depends on diagnosis, CT findings, symptoms, previous treatment and specialist recommendation.
Patients can also explore Ribera hospitals in Spain, request a second medical opinion or contact the team directly through Ribera Care International.
Request sinus surgery assessment in Spain
Chronic sinusitis can affect breathing, sleep, smell and quality of life. When symptoms persist despite medical treatment, an ENT specialist can assess whether FESS or another treatment option may be appropriate.
Send your ENT reports, CT scan results or previous diagnosis to Ribera Care International. Our team will help coordinate your case review and guide you through the next steps for sinus surgery planning in Spain.
