Louisville, Kentucky Commonwealth Ear Nose and Throat Specialist  

 UPCOMING EVENTS:
  

Doctor, What Should I Expect After Nasal or Sinus Surgery?

 

 

The following symptoms are to be expected. They will clear with time alone, but you may find these suggestions helpful in the healing process.

1. Stuffy Nose

As with any surgery, the tissues will swell. The openings to the sinuses and the delicate mucous membranes tend to become most swollen three to five days after surgery. A decongestant tablet, such as Sudafed® (pseudoephedrine), will decrease the amount of swelling. Keeping your head elevated, especially during sleep, will also help keep the swelling down. Keep your head elevated as much as you can tolerate for the first seven days after surgery.

Using the over-the-counter sprays, such as Afrin®, Duration, or Vicks®, will also shrink swollen tissues. Look for the ingredient, oxymetazoline 0.1 %, if you are shopping for generic sprays. This medicine works very well to decrease swelling. It can be used up to every 6 hours, but limit its use to three days only. Caution: this medicine will cause addiction if used longer than five to seven days. Expect some congestion when you stop using this medicine. Tissues swell as they withdraw from the usage of over-the-counter decongestant sprays.

Note: if you have high blood pressure, decongestants need to be taken with caution. Take your blood pressure twice a day when you are on these medicines. If the upper reading elevates over 160, or the lower number elevates above 95, then stop taking the medicines. Please inform us of this problem when you return for your followup care after surgery.

2. Drainage

Drainage is generally the most common, troublesome (but expected) result of sinus surgery. Expect this to be blood-tinged for the first two weeks after your surgery. Likely, there will be a slow, bleeding ooze for the first three days.

The best way to manage this drainage is to flush or loosen it with moisturizing saline (salt) water nose sprays or irrigations. It is perfectly acceptable to gently blow your nose through both nostrils to clear extra mucus. Do not pinch one nostril and blow forcefully, as this may only cause further bleeding.

It is generally better to sniff saline spray or irrigate the nose with saline than to repeatedly blow your nose to clear the mucus.

After a week or so, the drainage is likely to become colored -- typically yellow or green. Flushing with saline (salt) water spray is the best treatment. Don't be alarmed by the color of the drainage. Our noses are full of bacteria -- they get lots of new work after any nasal or sinus operation.

3. Bleeding From the Nose

Your nose is very unhappy for a few days after sinus surgery. The delicate membranes will likely respond by weeping, and the color is likely to be red for a few days. If bleeding does not respond to simple measures such as head elevation and pressure on the nostril, please read the separate instructions below for troublesome bleeding. The best advice we can give is to try to relax, and gently blow the nose to clear clots. Then use the saline irrigations or Afrin® nasal spray.

Please read over the instructions on "bleeding after nasal and sinus surgery". Become familiar with these instructions before you actually need them. If all measures fail - which occurs in approximately 1 in 100 patients, proceed to the emergency room listed on your materials, or if during office hours (Monday - Friday 8:30 a.m.-5:00 p.m.), please call our office for instructions.

4. Pain

Usually pain after sinus surgery is due to swelling of membranes. Try using the saline spray or irrigation to clear the nose of excessive mucus. Tylenol® extra-strength tablets (1 - 2 every 4 - 6 hours) will usually be adequate for mild to moderate pain. If you do not obtain relief, take the prescription pain medicines that were provided with your post-operative materials.

5. Nasal Packing

In a small number of patients, we insert sponge packing. If inserted, your doctor will give you instructions about removal. In addition, an absorbable plastic-like material is often inserted. This packing will be removed during a follow up visit. If you sneeze, and the packing comes out before that visit, don't worry -- we will just leave it out.

6. Fever

Most patients will run a low-grade fever for up to a week. This will respond to Tylenol® or your prescribed pain medications (which also contain Tylenol) in most cases. If your fever does not clear after one week, or elevates consistently above 101.5 degrees, call our office so that a visit can be arranged. Drinking plenty of fluids will help lower the fever also. A bath in room-temperature water is the quickest way to lower fever.

We unfortunately cannot treat a fever over the phone; if your fever is getting worse despite treatment, you will need to be seen by one of our professional staff.

7. Stitches

Routinely, we use absorbable materials. These may be seen as fine threads a week or so after surgery. There are no sutures that require removal. Any loose fragments will be removed during your follow up visits.

8. Follow Up Visits

A follow up appointment should be scheduled the same time we are scheduling your surgery. Follow up visits will be required every two to three weeks until the sinus cavities are completely healed (usually four to six weeks). If your surgery was performed only on the nasal septum, then a follow up visit is provided four to six weeks after the date of surgery.

9. Sneezing / Blowing the Nose

Try not to sneeze with your mouth closed for two weeks. If you must blow your nose to clear mucus, please gently blow without blocking either nostril. Just exhale through your nose with both nostrils.

10. Nasal Flushing with Saline (Salt) Water

Two methods may be used to flush the nose. Generally, I prefer to use a spray such as OceanTM Nasal Saline Spray Mist as often as practical for two to four weeks after nasal surgery (hopefully 6 - 8 times per day). Start with the flushes the day after surgery, and try to maintain a regular schedule every 1 to 2 hours (while awake).

Often, you will be instructed by our physicians to use a bulb suction and flush the nose. This is also fine, but requires more preparation. Hang your head over a sink, and flush until the drainage returns clear. [A recipe for saline (salt) water flushes is 1/2 teaspoon salt per cup of warm water]. Use this as often as practical, starting the day after surgery and continuing until all colored drainage has stopped (usually three to five weeks after surgery).

Lastly, no information sheet can cover all possibilities. If you have a question that is not covered by this material, call our office during regular hours (Monday - Friday, 8:30 a.m. - 5:00 p.m.) Please limit after office hour calls to very urgent questions. If you experience a true emergency, the best approach is to proceed to the emergency room.

We hope these materials are helpful to you. We know that any operation will cause discomfort and unpleasant effects; however, a few months from your operation, when everything is completely healed, you will most likely notice major improvements in your troublesome symptoms.

Thousands of other satisfied patients have already experienced much relief from their symptoms. Please let us know how we can be more helpful.

We welcome your suggestions and input. Satisfied patients are our only reason for being here!



  
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