Phone - (02) 9982 3439

Endoscopic Sinus Surgery Pre-Operative Information

Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon, specialist registration in Otorhinolaryngology, Head & Neck Surgery.

This page provides pre-operative and post-operative information for patients preparing for functional endoscopic sinus surgery (FESS). It should be read alongside the written instructions provided at your pre-operative appointment and the full post-operative care guide.

Read the full sinus surgery information page → | Post-Operative Care →


About Endoscopic Sinus Surgery

Functional endoscopic sinus surgery (FESS) is performed entirely through the nostrils using a fine endoscope and specialised instruments — there are no external incisions and no external scars. The procedure opens the natural drainage pathways of the sinuses, removes diseased mucosa and polyps where present, and restores ventilation of the sinus cavities. It is performed under general anaesthesia using total intravenous anaesthesia (TIVA) to minimise bleeding in the surgical field.

FESS is most commonly performed for chronic rhinosinusitis with or without nasal polyps that has not responded adequately to medical therapy. It is frequently combined with septoplasty and turbinoplasty in the same anaesthetic. Medicare and private health insurance rebates apply.

Post-operative care after sinus surgery — particularly regular saline nasal irrigation and attendance at post-operative debridement visits — is critical to a good outcome and is as important as the surgery itself.


Before Surgery

Medications to Cease

Stop the following at least two weeks before surgery:

  • Aspirin and aspirin-containing products
  • Ibuprofen (Nurofen, Advil) and all anti-inflammatory medications
  • Naproxen (Naprosyn, Naprogesic)
  • Warfarin, clopidogrel, or other anticoagulants — discuss with Dr Roth and your GP before stopping
  • Vitamin E supplements, fish oil, garlic tablets, ginkgo biloba, ginseng, St John’s Wort

A full list is available on the Medications to Avoid page →

Nasal Steroid Sprays

Continue your prescribed nasal steroid spray right up until the day of surgery — do not stop it. For patients on oral corticosteroids, specific guidance will be given at your pre-operative appointment.

Fasting

  • No solid food or milk for at least six hours before your scheduled surgery time
  • Clear fluids permitted up to two hours before — confirmed by the hospital the day before surgery

Practical Preparations

  • Arrange a responsible adult to drive you home and remain with you on the first night
  • Purchase a large-volume saline nasal irrigation kit before surgery — NeilMed Sinus Rinse or Flo Sinus Rinse. Twice-daily irrigation beginning the day after surgery is the single most important thing you can do to ensure a good surgical outcome
  • Plan at least one week away from work; two weeks off strenuous exercise
  • Have all prescribed medications ready before your surgery date

What to Expect in Recovery

Night of surgery
Most patients are discharged the same day. The nose feels very blocked and congested. Some blood-tinged nasal discharge is normal and expected. Rest with head elevated. Do not blow the nose.

Days 1–7
Begin saline nasal irrigation the morning after surgery — twice daily, every day. Nasal congestion is prominent but gradually improving. Some crusting is expected. Avoid nose-blowing, straining, and strenuous activity. Use Drixine decongestant for no more than three days.

Week 1–2 — debridement appointments
Post-operative debridement appointments are essential. Dr Roth will use microsuction to clean crusting and debris from the surgical cavities, check healing, and remove any dissolving spacers. These visits are included in the surgical fee. Missing them significantly worsens outcomes.

Weeks 2–6
Nasal breathing and sinus symptoms improve progressively. Resume normal activities as tolerated. Continue twice-daily saline irrigation — this is particularly important in the first six weeks. Nasal steroid spray resumes as directed.

Months 2–6
Sinus cavities fully re-mucosalise and heal. Symptoms continue to improve. The full benefit of the surgery is typically apparent by three to six months. In patients with nasal polyps, ongoing medical therapy is essential to maintain the result.


Important Post-Operative Instructions

  • Twice-daily saline nasal irrigation is not optional — it begins the day after surgery and continues for at least six weeks. Use a large-volume delivery bottle
  • Attend all scheduled post-operative debridement appointments — these are as important as the surgery itself
  • Avoid nose-blowing for the first week; thereafter blow very gently
  • If sneezing is unavoidable, open the mouth widely
  • Avoid strenuous exercise, heavy lifting, and bending forward for two weeks
  • Avoid alcohol, hot showers, and steam in the first week
  • Take paracetamol for pain — avoid all anti-inflammatory medications after surgery
  • Complete the full course of prescribed antibiotics
  • Keep irrigation bottles clean and dry between uses; always use cooled boiled or sterile water

When to Seek Urgent Assistance

Contact Dr Roth immediately or attend your nearest emergency department if you experience:

  • Brisk bleeding that does not settle after 20 minutes of firm direct pressure
  • Fever above 38.5°C
  • Increasing pain, redness, or swelling around the wound
  • Any purulent (cloudy or discoloured) discharge

Dr Roth’s rooms: (02) 9982 3439 | Out of hours: attend the nearest emergency department.

Attend emergency immediately if you develop: severe headache, stiff neck, visual disturbance, or high fever with confusion — these may indicate a rare intracranial complication and require urgent assessment.

Sinus Surgery — Full Information → | Post-Operative Care → | Contact the Rooms →

Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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