Sinus Surgery Pre & Post Operative Instructions
Surgery can improve drainage and relieve many sinus symptoms. The technique may be limited to working inside the nose with a nasal endoscope, allowing your surgeon to clear blockages and obstructions with little damage to the surrounding tissue. Alternatively, an incision may be necessary to get to areas that are not easily reached with the nasal endoscope.
Postoperative debridement of your nose is an indispensable part of the surgery and helps relieve persistent or recurrent sinus disease. This involves several visits to our office for 4 to 6 weeks after surgery. These post-operative visits should be anticipated when scheduling your surgery date. Additionally, HMO patients must bring a separate referral for the "post-operative nasal endoscopy" to each of these visits. You may wish to obtain these from your primary care physician in advance.
As with any surgery, you run a slight risk of infection and bleeding. When incisions are required, your risks also include numbness in your front teeth and scarring. We ask that you read over the FESS handout, which reviews endoscopic nasal surgery including its benefits, risks, and limitations. Your physician will discuss any additional risks, which differ, depending on the type and location of your surgery.
Here are a few things you can do before surgery to help things go more smoothly:
- Purchase a Neil Med® Sinus Rinse Kit for salt water rinses you will do after surgery. These are available at our offices and area pharmacies.
- Eliminate aspirin products 2 weeks before surgery. Ibuprofen (Advil, Motrin, Aleve) should be stopped 5 days before surgery.
- Tell your doctor about any medications you are taking and ask whether you should take them the morning of surgery.
- Stop smoking at least 3 weeks before your surgery date.
- Arrange for a ride home after the procedure.
Expect the procedure to last from 1 to 3 hours. It can be done either under local anesthesia with sedation or under general anesthesia. During surgery, your doctor will either work with an endoscope inserted through your nose, or make an incision through skin or over your gums.
You can expect some nasal stuffiness and crusting for 3-6 weeks after surgery. Many patients are back to work or school the week following surgery. Following these suggestions can help you prevent complications and recuperate more quickly.
The First Few Days
- Change the gauze bandage under your nose (if present) as needed. Discontinue when the drainage stops.
- Sleep with your upper body elevated to keep pressure off of your head.
- Use pain medication as directed by your doctor or mild non-aspirin pain relievers (Tylenol).
- Take any additional medications prescribed by your doctor.
- Drink plenty of fluids to prevent dry mouth. A bedside humidifier may be helpful.
- To help control any bothersome nasal bleeding, an icepack can be applied over the nose and cheeks. Tilt your head forward while sitting up and breathe gently through your nose. Do not snort the blood through your nose as this will promote more bleeding. If bleeding continues, Afrin or Neosynephrine nasal decongestant spray (1-2 sprays in each nostril) may be used sparingly every 6 to 8 hours for 1-2 days.
The First Few Weeks
- Use salt water (saline) rinses beginning 1 to 2 days after surgery to wash away any crust and surgical debris. Use the Neil Med® Saline Rinse in the bottle to squirt the solution into your nose a few times a day. Afrin or Neosynephrine nasal decongestant spray will open the nasal passage and may be used just before rinsing with salt water.
- Your doctor may recommend that you use a nasal steroid spray 15-30 minutes after using the salt-water rinse.
- You will need several visits after surgery to clear out old blood and mucus. During these visits, any persistent inflammation or scar tissue will be removed after a topical anesthetic is sprayed into the nose . For your comfort, we recommend that you take a dose of your prescribed pain reliever immediately before these visits. (Do not take pain medications on an empty stomach). You will need a ride to the first post-operative appointment.
- For several weeks, you will have some thick discolored drainage from your nose. This occurs as the sinuses begin to clear themselves. This is normal and does not indicate an infection.
- Take it easy and avoid bending, straining, and exercise for at least 1 week. No vigorous activity is allowed until healing is complete, usually in about 2 weeks.
- Severe diarrhea from antibiotic usage can be a sign of a serious medical problem. If this occurs, stop taking the antibiotic.
- Cough and sneeze with your mouth open.
- Do not blow your nose during the first week. During that time, if you have congestion, sniff gently and spit into a tissue.
- Avoid hot, spicy foods.
- Do not drink through a straw.
CALL YOUR DOCTOR IF:
- You are bleeding excessively.
- You have signs of an infection such as fever, yellow-green drainage, unrelieved headache, or increased pain.
- You have decreased or double vision, swelling of the eyes, a stiff neck, or extreme fatigue.
- You have clear watery drainage from your nose.