Question

During functional endoscopic sinus surgery (FESS), the patient is usually placed in which position?

• A. Trendelenburg
• B. Lateral
• C. Reverse Trendelenburg
• D. Lithotomy

Hint:

You want the head above heart level to keep the sinus field dry.

Answer 1

The Correct Option is C

Step 1: FESS is performed inside the nasal and paranasal sinus cavities where even minor bleeding badly obscures the endoscopic view, so positioning aims to keep the operative field as bloodless as possible.

Step 2: In the reverse Trendelenburg position the head end of the table is raised so that the head sits above the level of the heart. This lowers venous and arterial pressure at the surgical site and reduces intraoperative blood loss.

Step 3: Because it is safe, simple and cost-free, the reverse Trendelenburg (head-up) position is the standard for FESS, making option c correct.

Step 4: The Trendelenburg (head-down) position would increase venous congestion and bleeding, while the lateral and lithotomy positions are used for other types of surgery, so they are incorrect.