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Introduction: Functional endoscopic sinus surgery (FESS) under local anaesthesia performed as an office-based procedure is an alternative to general anaesthesia. It is gaining popularity among otorhinolaryngology – head and neck surgeons. Aim: This study assesses the outcome of FESS performed under local anaesthesia in a tertiary centre over a 5-year period. Material and methods: A retrospective data collection was conducted. All adults who underwent FESS under local anaesthesia for a 5-year period from June 2014 to June 2019 in Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) Department, Sarawak General Hospital, Malaysia were included in this study. Data and information on preoperative assessment, surgical indication, sinuses operated on, intraoperative findings and postoperative complications and follow up were recorded. Results and discussion: A total of 150 patients met the inclusion criteria. The most common indication was chronic rhinosinusitis with nasal polyp (78%). All paranasal sinuses were operated on. In 43% of cases local anaesthesia was used alone, while 57% received both local anaesthesia and intravenous anaesthesia. Majority of patients (90%) were discharged home the next day. Four patients (2.7%) developed epistaxis postoperatively which did not require surgical intervention. Conclusions: FESS under local anaesthesia is a safe and feasible alternative to general anaesthesia and is well tolerated by patients. Complications of general anaesthesia can be avoided.

Inverted papilloma is a benign sinonasal epithelial tumour that mainly occurs in the fifth to sixth decades of life, with male predominance. The incidence in the young adolescent population is comparatively lower. The clinical and radiological findings may mimic other benign sinonasal tumours, so the diagnosis can only be confirmed by histopathological examination. Consequently, precise diagnostic and therapeutic planning is recommended to achieve the optimal result. We describe a case of unilateral sinonasal tumour in a young adolescent male who showed clinical and radiological features of juvenile nasopharyngeal angiofibroma, such as widening of the sphenopalatine foramen, extension of the mass posteriorly towards the nasopharynx, and presence of flow voids that suggested highly vascular nature of the mass. However, a postoperative histopathological examination showed a diagnosis of inverted papilloma.