RECOVERY FROM NOSE & SINUS SURGERY
There are many different operations that are performed on the nose and sinuses, however the recovery from these procedures often follows a similar course. Procedures that this advice sheet is intended for include:
FESS (Functional Endoscopic Sinus Surgery) – an operation to widen the narrow drainage channels of the sinuses. This type of surgery is performed using a telescope (endoscope) that is inserted into the nose. It is usually performed to improve symptoms due to acute or chronic sinus infections
Septoplasty – an operation to straighten the middle partition of the nose. This is usually done to improve breathing through the nose.
Reduction of turbinates – this procedure involves reducing the size of the turbinates. The turbinates are natural swellings inside the nose that can contribute to a blocked nasal airway.
Balloon sinuplasty – this involves inserting a deflated balloon through the narrow channels that drain the sinuses. The balloon is then gently inflated to widen the drainage channels. It is performed to improve the ventilation of the sinuses and treat sinus problems. It is sometimes performed as part of FESS.
Nasal polypectomy – this is an operation to remove nasal polyps. It is often performed using telescopes in conjunction with FESS.
How long does nasal surgery take?
The length of surgery depends on the nature of the operation. Most nasal operations take from 15 to 45 minutes. More complex procedures can take a couple of hours.
Will I be asleep for my procedure?
Most nasal procedures are performed under general anaesthetic, so you will be asleep for the duration of your operation. Some procedures, such as balloon sinuplasty, can be performed under local anaesthetic if required by numbing the nose with injections and sprays.
What happens after my operation?
After your surgery, you will be taken from the operating theatre to the recovery ward where you will wake up from your anaesthetic. Once you are fully awake, you will be taken back to your room. You can usually have something to eat about an hour after your operation.
As the nose has a rich blood supply, it is normal to have a small amount of bleeding from the nose after the operation. You will have a gauze dressing taped underneath the nose to catch any ooze that comes from the nose. Very occasionally some dressings (or “packs”) will be put in the nose. If this is necessary, they will usually be removed after a couple of hours.
How long will I be in hospital for?
Most nasal operations take place as day case procedures and you can leave hospital a few hours after the procedure. If you have other health problems or are having complex procedure performed, an overnight stay may be required.
Caring for your nose at home
It is normal to have a blocked nose after nasal surgery. Often the nose is clear immediately after the operation, but gradually blocks up over the next few hours. It is common for the nose to be blocked for three weeks before the nasal airway begins to improve. This is because the nasal airways are narrow, and even a small amount of swelling of the lining of the nose can cause a blocked nose. Usually you will have some watery blood-stained discharge from the nose, which settles after a few days. Occasionally some crusts or scabs will form in the nose as part of the healing process. Please resist the temptation to pick these out, as it could cause a nosebleed, or infection in the nose. You can use saline washes to help clear them.
You will usually be given some drops and washes to use in the nose after your operation. These can be sniffed through the nose to help clear the nasal airways.
You should not fly for three weeks after nasal or sinus surgery as the cabin pressure changes and very dry air increase the risk of having a nosebleed.
Occasionally patients who have had a septoplasty or septorhinoplasty experience some numbness or tingling of the tip of the nose or front, upper, teeth. This is caused by irritation of the nerve that supplies the area, which runs along the bottom of the nasal septum. In most cases this will settle with time, although it can take several months as nerves heal very slowly.
Some discomfort is normal after surgery to the nose or sinuses, but it should not be very painful. If you do have problems with significant pain (such as pain that does not respond to simple painkillers such as paracetamol or ibuprofen), please contact me. Pain can be a sign of a sinus infection, or a clot underneath the lining of the septum ("septal haematoma"). If left untreated, a septal haematoma can give rise to a hole in the middle partition of the nose ("septal perforation").
When can I go back to work?
It is advisable not to go to work or attend social gatherings for two weeks after most nasal operations. This is mainly to avoid contracting any infections whilst your nose is healing.
After balloon sinuplasty or reduction of inferior turbinates, you can usually return to work after two days.
Tips & tricks for caring for your nose after nasal surgery:
- For the first couple of days after your operation, it is helpful to sleep with your head propped up with more pillows than usual. This reduces the blood pressure on the inside of the nose, and can reduce both bleeding and swelling on the inside of the nose.
- Unless advised by your doctor, don’t take aspirin as this thins your blood and increases the length of time it takes for blood to clot.
- Although it is fine to sniff through your nose after your operation, you should try and avoid blowing your nose for two weeks after surgery, as this increases the chances of having a nosebleed.
- Don’t take any vigorous exercise, lift anything heavy or strain excessively for four weeks after surgery, as this can also increase the risk of having a nose bleed.
- Smoking causes inflammation in the nose. It slows the healing process and makes complications, such as nosebleeds and infections more likely. It is very helpful to stop smoking both in the run-up and recovery from nasal surgery. Your GP practice should be able to give you advice on how to stop if required.
- If you do need to sneeze, this is best done through your mouth. You may wish to gently bite your finger to make sure you do!
- Avoid crowded places and social events whilst recovering, to reduce the chance of catching a cough or cold, which would slow down your recovery.
- If you do have a nosebleed, pinch your nostrils together. Don’t squeeze your nasal bones, as this won’t do anything. Put your head forward, and spit out any blood that runs down your throat (If you swallow blood, it can irritate the lining of the stomach, and make you feel sick). It can also help to put an ice-pack (or some frozen peas) over your forehead and the bridge of your nose, and to suck an ice-cube.
If you have any: green or mucky discharge from the nose; a raised temperature; a nosebleed you can’t control; increasing pain; or any other queries, please contact me on firstname.lastname@example.org or 01892 740671, or the hospital where you had your operation.