Sinus Surgery

Post-Operative Instructions

REMEMBER: No food or drink after midnight on the night before surgery.

For two weeks before and after surgery, use ONLY Tylenol (acetaminophen) for any fever or discomfort. Your doctor wil prescribe pain medicine after surgery. DO NOT use aspirin, ibuprofen, or similar products (Motrin, Aleve, Advil, Pediaprofen, etc.)

Keep head elevated on several pillows when lying down for one week after surgery. This will help keep swelling and congestion to a minimum. Ice packs can also be used on the face and eyes for the first 12 - 24 hours after surgery (10-15 minutes at a time, about 30-60 minutes apart)

Use saline nasal spray (2 sprays each nostril), every 3 hours while awake ;until your return visit. This will help keep the nose moist and clean. Several name-brand (Ayr, Ocean, etc.) and generic forms are available.

If there is bleeding after surgery, you may use Afrin or similar decongestant spray in each nostril  (2sprays, twice a day). If the bleeding doesnt improve, call the office or on call nurse. 

Do not blow your nose for one week following your nasal or sinus surgery. If you must sneeze, do so only with your mouth open.

Do not lift anything greater than 10 pounds for one week after surgery. Also, no bending over or straining should take place during this time.

Call the clinic or ENT physician on call for any problems you may have, such as:

Excessive bleeding

Visual changes or eye pain

Excessive nasal congestion or nasal pain not relieved by pain medicine

A follow up clinic visit will be 1 week after surgery. This is an important visit to monitor how the nose is healing and to check on any problems you may be having.

If you have other questions or problems, please call:

Tupelo Office: 662-844-6513

Nurse Link: 1-800-882-6274

Tupelo Hospital: 662-377-3000

Nurse Link: 662-377-3007 for the on call ENT nurse or physician

 

Sinus surgery is a very safe procedure, but before having this done, there are some things you ought to know. Any surgical procedure may have complications, both major or minor. Although relatively safe, there have been deaths related to sinus surgery. The main risks are related to being put to sleep (eg. A reaction to the medication used to induce anesthesia, or trouble inserting the breathing tube), or surgical damage to the surrounding areas (brain or eye).

Sinus surgery is usually done completely through the nose with no external incisions. This leads to less swelling and pain. Also, you shouldnt look like you were just run over by a truck after surgery. Instruments are used to allow us to see in the nose and remove tissue that is blocking up the sinuses.

The normal postoperative course includes two weeks of swelling, and stuffy nose. The nose is also tender for several days after surgery. Sometimes, splints or packing are placed in the nose during surgery for various reasons. This should be removed within 1 week after surgery, and is done in the office.

Spinal fluid leak is very uncommon after sinus surgery, but it has been reported. The symptoms of this are a clear drainage from the nose, particularly when tilting the head forward. If you have concerns about this, you should inform you physician and be seen by them.

The other major surgical risk is of injury to the eye. During sinus surgery, your surgeon is very close to the eye and the brain. There is only a thin piece of bone between the sinuses and the orbit (eye socket) as well as the brain. There may be simple bruising and swelling in the eye, or the problem may be as severe as double vision or blindness in the eye. It is not unusual to have some minimal blurred vision after sinus surgery that will resolve on its own, however, any changes in your vision should be reported to the doctor.



If balloons were used for your surgery, your doctor may allow normal activity after 24 hours. This includes bending, lifting and blowing your nose.

Functional endoscopic sinus surgery (FESS): Developed in the 1950s, the nasal endoscope has revolutionized sinusitis surgery. In the past, the surgical strategy was to remove all sinus mucosa from the major sinuses. The use of an endoscope is linked to the theory that the best way to obtain normal healthy sinuses is to open the natural pathways to the sinuses. Once an improved drainage system is achieved, the diseased sinus mucosa has an opportunity to return to normal.



FESS involves the insertion of the endoscope, a very thin fiber-optic tube, into the nose for a direct visual examination of the openings into the sinuses. With state of the art micro-telescopes and instruments, abnormal and obstructive tissues are then removed. In the majority of cases, the surgical procedure is performed entirely through the nostrils, leaving no external scars. There is little swelling and only mild discomfort.



The advantage of the procedure is that the surgery is less extensive, there is often less removal of normal tissues, and can frequently be performed on an outpatient basis. After the operation, the patient will sometimes have nasal packing. Ten days after the procedure, nasal irrigation may be recommended to prevent crusting.

Reference: American Academy of Otolaryngology. Head and Neck Surgery. http://www.entnet.org/HealthInformation/SinusSurgery.cfm