If the infection does not respond to medication and keeps coming back, the doctor might perform endoscopic sinus surgery (ESS). ESS is frequently performed on an outpatient basis under local or general anesthesia. The ENT surgeon inserts a thin fiber-optic tube into the nose that allows him to examine the sinus openings. He is then able to remove the tissues that are obstructing the passages using state-of-the-art instruments and micro-telescopes. You experience no scarring, minimal swelling and only mild discomfort.