Nasal Sinus Surgery

Postoperative Instructions for Nasal (Septoplasty) Surgery and Sinus Surgery

Nasal Drainage: Mucous mixed with blood is expected and may continue until your nasal packs or splints are removed. Blood clots may be noted for up to 2 weeks after packs are removed. At the surgery center you will be given gauze pads (dripper pads) and a holder to catch and absorb this drainage. Change your gauze pad as needed. Drainage slows over the first few days and may stop completely. If drainage stops, you may discontinue using the gauze pads. If bleeding seems excessive, e.g. a constant bright red drip for more than ten minutes, call our office for further instructions. If you have internal splints, we recommend gently cleaning your nostrils twice daily with hydrogen peroxide using Q-tips or cotton swabs, and then applying an antibiotic ointment such as Bacitracin or polysporin. These items are available over the counter at any pharmacy. Once your packs or splints are removed, you will be given instructions on how to care for your nose by our nursing staff. Following your pack or splint removal, you can blow your nose lightly through both nostrils at the same time with your mouth open.

Sneezing: Don’t worry – go ahead and sneeze with your mouth open. Do not pinch or cover both nostrils shut and hold a sneeze back.

Pain: Pain is moderate to moderately severe the first 24-48 hours but begins to decline thereafter.  Following removal of your nasal packs or splints discomfort falls dramatically. Use your pain medication as prescribed. The sooner you can reduce your narcotic medication use, the quicker your recovery is.  As your pain lessens, try using extra-strength acetaminophen (Tylenol) instead of your narcotic medication. Some people experience discomfort or numbness of the upper teeth, which generally resolves within a few weeks.

Nausea and Vomiting: This is common in the first 24 hours. It generally resolves on its own. If you feel it is excessive or does not resolve after 24 hours, call our office for further instructions. Narcotic medication may contribute to nausea and may be better tolerated if taken with food.

Constipation:  PATIENTS MAY EXPERIENCE CONSTIPATION WHILE TAKING NARCOTICS AND EATING A LOW FIBER DIET. PLEASE TRY TO MINIMIZE NARCOTICS.  TRY TO EAT SOME SOFT FOODS WITH FIBER: E.G. APPLE SAUCE, BANANAS AND BERRIES. ONE CAN BLEND SOME FRUITS WITH ICE FOR A COOL “SMOOTHIE” DRINK.

Swelling: Facial swelling, if it occurs, is usually minimal around the nostrils and upper lip area. It is normal to have minimal or no facial swelling. Swelling inside your nose (areas of surgery) is expected.  50-60% of swelling inside your nose is resolved by 2 weeks. Swelling continues to resolve rapidly thereafter, but your final nasal breathing result is not achieved until 2-3 months following surgery. It just gets better over time.

Bruising: Occasionally some bruising occurs around the lower eyelids and cheeks. If bruising occurs, it usually resolves in 10 –14 days, fading from black to brown to yellow until gone.

Fever: A low-grade temperature (100 degrees) and even an occasional elevated temperature above 101.5 degrees or higher are not uncommon. Should you have a temperature of 101 degrees or higher, take a deep breath and cough (once or twice) every 15-30 minutes and increase your fluid intake.  Deep breathing and coughing opens the lungs and reverses a common cause of elevated temperature.  If your elevated temperature persists for 1-2 hours, call our office for further instructions. Please measure your temperature. Patients will often think they have an increased temperature because they feel warm.

• Note: There are extremely rare reports of toxic shock syndrome developing with nasal packing. The symptom combination includes a sunburn-like rash on the palms or soles of the feet, diarrhea, extreme lightheadedness and high fever. If you have this combination of symptoms, please call us immediately.

Diet: Resume your diet as tolerated. Avoid alcohol while you are taking any narcotics.

Bathing: If you feel well enough you may shower. If you have a nasal cast, try to keep it dry. Avoid hot baths or hot tubs until after the packing and/or splints have been removed. Clearance from your doctor is recommended.

Nasal Congestion and Pressure Sensation: This is expected and is due to tissue swelling in the areas of surgery. As swelling resolves, these symptoms will also resolve.

Dry Lips: Your lips will frequently feel dry due to your mouth breathing. You may use Vaseline, Chap Stick, etc. as needed. If available, use a humidifier to reduce or prevent dryness of the lips, mouth and throat.

Energy Level: Typically, you will regain 80% of your energy level back after one week, at which time you may return to work if your doctor and you feel you are ready. Sometimes additional recovery time is needed. In general, it takes approximately 3-4 weeks total to be 100%. It is not uncommon for patients who undergo sinonasal surgery to feel more energetic than before surgery.

Sleeping & Resting: Keep your head elevated 30-45 degrees above horizontal following surgery for the first 7-10 days.

Activity Level: For the first 10 days you are restricted to light activity. Do not lift objects greater than 10 pounds. Bend at the knees, not at the waist. Do not engage in activities that will elevate your heart rate and blood pressure, and do not get overheated (e.g. sunbathing, sauna/hot tub, etc.). After 10 days, if you are doing well, increase your activity level as tolerated. Swimming, heavy aerobic, weight training, and other strenuous activity should be deferred for 1 month. Activities with a risk of nasal injury (diving, water/snow skiing, contact sports, etc.) should be deferred for 2 months.

Return to Work: Most patients can return to work in 7-10 days; some patients will require additional time. Discuss returning to work with your doctor at your first post-operative visit.

Injury to the Nose: Many patients sustain accidental blows to the nose from a variety of causes (pets, children, and other reasons) following surgery. Following surgery, your nose is strong enough to tolerate some blows. However, if nasal bleeding or dramatic swelling occurs following a blow, call our office for further instructions.

Other Questions: For non-emergent questions, please call our office at (503) 581-1567, between 9:00 am and 3:00 pm Monday through Friday. For emergent questions, call our office and our answering service will page the doctor on call. We have a doctor on call 7 days a week.