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Septoplasty and/or endoscopic sinus surgery post-operative instructions

TIER ENT ASSOCIATES, P.C.
15 Riverside Drive
Johnson City, NY 13790
607-770-9050
Septoplasty and/or Endoscopic Sinus Surgery post-operative instructions
Items typically needed:
Medications:
Unless otherwise stated, antibiotics should begin the day after surgery if no significant nausea or vomiting have occurred.
Prescription pain medicine is almost always needed and should be used as instructed for adequate pain control. Side effects
may include nausea, vomiting, drowsiness or constipation. If pain is not severe or if prescription medication is not tolerated
then Tylenol (acetaminophen) or Extra-strength Tylenol may be used. NO other pain medications are to be used! (ex:
Advil, Ibuprofen, Aleve, Naprosyn, Aspirin, etc.) Pain can be intense after the surgery. Some swelling of the nose may
occur. Ice packs may be used if desired.
Bleeding:
Bleeding from the nostrils and down the back of the throat is common and expected after surgery. Typically, up to 4-5 4” x
4” gauze pads may be soaked each hour, although most people experience less bleeding. If more bleeding occurs call the
office. If the bleeding is not significant, many patients choose to wear an old shirt and dab the drainage with a cloth as
continued tape may irritate the cheeks. Blood in the throat may be expectorated or cleaned with a salt-water gargle or a small
amount of hydrogen peroxide mixed with water for a gargle. If vomiting occurs then significant blood may be seen or it may
appear like “coffee grounds”.
Nausea and vomiting:
Nausea and vomiting is possible and may be secondary to the anesthetic especially in the first 1-2 days. If it is severe and for
a prolonged period of time call the office.
Nasal splints:
If a septoplasty was performed, plastic nasal splints may be evident. If a stitch breaks, a small amount of bleeding may occur
but is not cause for alarm. The nostrils may be cleaned of mucous, blood and crusting with hydrogen peroxide on a Q-tip or
gauze. The eyes often water excessively after the surgery. This is normal as the tears (which are normally made) drain into
the nose, but with the swelling this may not possible. You may sniff in but no blowing of the nose for at least one-month
after surgery. Some numbness to the upper teeth and/or palate may occur and is almost always a temporary sensation from
nerve inflammation.
Fever:
Fever is fairly common, especially in the first several days and may be secondary to anesthesia. Occasional deep breathing
may help reduce fever and help prevent post-operative pneumonia or bronchitis.
Activity:
NO
heavy lifting, bending over or vigorous activity for several weeks after surgery. Many people are more comfortable
sleeping somewhat upright on several pillows.
Diet:
Liquids and bland soft foods are typically best for the first day or two. If no significant nausea has occurred then diet may be
advanced to regular diet as tolerated.
Follow-up care:
Most individuals are scheduled for an office appointment 6-7 days after surgery. At this time, splints (if a septoplasty was
performed) will be removed. Pain mediation is recommended before this appointment, as it can be uncomfortable although,
fortunately, it only takes several seconds. After this appointment NO nose blowing is further emphasized (for one full
month). Nasal saline spray (ex. Ayr or Ocean Nasal Spray, etc.) is to be sniffed up the nose 5-10 times per day. The spray is
meant to provide hygiene to the inner nose and prevent excessive scabbing and crust formation. Hydrogen peroxide may still
be applied to the nostrils for cleaning. Increased active bleeding may occur after splint removal. Bleeding may occur
typically up to one week after surgery. Nasal breathing usually is quite good after the splint removal but may become
congested due to swelling, crusting and clots. Finish the antibiotic course and use pain medication as needed. Occasionally
some crusting occurs, especially in the left front nasal cavity. A thin coat of Bacitracin ointment may be applied to keep the
crust and stitching soft.
At 2 weeks after surgery activity may be increased as tolerated. Decongestants such as Sudafed may be used as needed, if not medically contraindicated. 2-3 weeks after surgery it is not uncommon to develop significant sinus pressure and pain. This is often due to crusting and scabs that block the sinus drainage pathways. Increase saline use, decongestants or possible steam may help improve this. If obvious infection occurs with purulent drainage that persists or significant fever call the office for possible antibiotic course. The next routine appointment is often 4-6 weeks after surgery. The nose may still be tender to touch, which may exist for months. After this appointment, nasal steroids may be resumed if used pre-operatively.
The above serves as a guideline for basic post-operative care. If significant problems or questions arise, please call the office.
Hopefully, your post-operative recovery will be uneventful and without much discomfort. My office staff and I will do our best to assist you and ensure a positive outcome to your surgery. We certainly want nothing less for our patients than to have a successful experience and recovery.
Jeffrey M. King, M. D., F.A.C.S.
M. Sujana Kantharaj, RPA-C

Source: http://www.tierentassociates.com/files/sinus-aftercare-instructions.pdf

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