Nose & Sinus Surgery Post Operative Care

Surgery of the nose is generally very safe and much of the work is performed inside the nasal cavity and sinuses where it cannot be seen externally. It is important to remember that significant healing occurs on the inside of your nose and sinuses, and this can take a number of weeks or months to complete.

Leaving Hospital

You will need someone to collect you from hospital and take you home. Most patients go home on the day of surgery. Some procedures require an overnight stay. Prescriptions will be given either before or after surgery and may include:

• Antibiotics — only routinely prescribed when a foreign body (such as a nasal splint) is left inside the nose. Always complete the full course. Increase intake of good bacteria (yoghurt, probiotic supplements) during any antibiotic course.
• Nasal decongestant (e.g. Drixine) — optional. Can be used every 6 hours but must be stopped after 3 days. Most effective after nasal irrigation.
• Sinus rinses — see nasal washing section below.
• Steroid tablets — prescribed for selected patients with chronic sinusitis and nasal polyps.
• Pain relief — prescribed by Dr Roth or the anaesthetist depending on the procedure.

Nasal Packing, Splints and Spacers

In the vast majority of cases no nasal packing is required. If packing is used, it will be removed before you leave hospital. A soft silastic splint may occasionally be placed to support a deviated septum or prevent bleeding within the septum — this is removed at the one-week post-operative visit. Spacers used after extensive sinus surgery are removed after one week. Keep splints moist to prevent crusting.

Nasal Washing (Irrigation)

Nasal irrigation is an important part of post-operative care. Start the day after surgery. Use a large-volume delivery bottle (NeilMed Sinus Rinse or Flo Sinus Rinse). Always use boiled water (cooled) or sterile water. Keep the bottle dry between uses, store with the lid off, and clean regularly.

At Home

Allow at least one full week to recover, followed by two further weeks off strenuous activity and heavy lifting.

• Avoid straining, heavy lifting, bending over, or activities that raise your blood pressure
• Avoid hot spicy foods and steaming hot showers in the first week
• Gentle nose blowing is permitted 48 hours after surgery — nasal irrigation is preferable to blowing as it reduces bleeding risk
• If you need to sneeze, open your mouth widely to release pressure

Pain

Nose and sinus surgery is usually not particularly painful, though this varies. Pain may be referred to the ears, face, or teeth. A sore throat from the anaesthetic tube is common for a day or two. Most pain settles within 2–3 days. Take pain medication regularly rather than waiting for pain to build.

Bleeding

Some on-and-off bleeding for up to 14 days after surgery is expected. If brisk continuous bleeding occurs:

1. Apply ice to the face, back of neck, or suck ice cubes
2. Sit upright, leaning slightly forward — do not tilt the head back
3. Squeeze the nostrils shut and hold firmly for 20 minutes
4. Do not blow the nose
5. If bleeding does not slow after 20 minutes — contact Dr Roth and attend your nearest hospital. Call an ambulance if necessary.

Follow-Up

Attendance at all post-operative appointments is important. The first visit is usually at one week, when any splints or spacers are removed and the nose is gently cleaned.