Most sinusitis can be treated with medication, but for a small percentage of chronic cases, surgery is required. As with any other surgical procedure, sinus surgery requires meticulous aftercare to ensure that healing takes place as quickly as possible, and pain can be managed effectively. As endoscopic sinus surgery is generally performed on an outpatient basis, a patient will have to manage their own aftercare at home. It’s important to know what to expect, what to do, what not to do, and when to contact your healthcare provider. Here’s what to expect at home.
What is endoscopic sinus surgery?
If you have badly damaged sinus tissue, benign growths (called polyps), a fungal infection or structural problems that are preventing your sinuses from draining, you may need to have surgery. Endoscopic sinus surgery opens the natural drainage pathways of the sinuses, which may have become blocked due to sinusitis. Fluid trapped due to inflamed pathways can cause infections, and so the aim is to remove the blockage, which can be caused by delicate bones or mucus membrane. Endoscopy allows surgery to be performed without incisions, using small fibre optic telescopes that are inserted into the nostrils.
When you get home
You’ll still have mucus and blood coming from your nose – you can expect this for 1-2 days, and you’ll need a drip pad. The pad will need to be changed, possibly once an hour, until the bleeding stops. Some areas of your face may be swollen – upper lip, cheeks, nose and eyes – and your nose will likely be sore. For several days following surgery, you may feel congested – this is normal – and you may have other symptoms associated with a moderate head cold. But most good doctors suggest that you should be back to work after two days, depending on your recovery time. You may also experience some numbness – this can last quite a while, sometimes for months, but is nothing to worry about. It’ll gradually come back. Your sense of smell may not be as strong as it was before surgery.
Wound care
When your wound begins to bleed, tilt your head back and breathe gently through your mouth. Do NOT blow your nose – you won’t be able to do so for at least a week. No-one can help sneezing though, so don’t try to stifle a sneeze – but keep your mouth open. Once the bleeding becomes lighter you may not need a drip pad, and you can dab at your nose with soft tissue instead.
You may see dark brown, thicker discharge from your nose, or even thick yellow or white matter for days or even weeks after surgery. Don’t panic – this is normal, and isn’t a sign of infection.
Your doctor should instruct you on how to clean the inside of your nose with saline. This usually has to be done twice a day unless your doctor states otherwise, and is an important part of post-operative care. Cleaning helps recovery time, and makes follow-up appointments smoother and less unpleasant.
Medicines
Congestion can be a problem when recovering from sinus surgery, and over-the-counter nasal sprays can be used for some relief. Bear in mind that these can usually only be used for 3-4 days before they become ineffective (and in some cases worsen the congestion).
Antibiotics or oral steroids may be prescribed to counter the facial swelling. Consult your doctor if you have any side-effects, such as severe diarrhea. Discontinue usage until you’ve consulted.
You will probably be prescribed some pain-relief medication to help in the early stages of aftercare. This should be taken as directed, but make sure to take it 45 minutes before your first post-op visit, as this will involve cleaning and examination. Over-the-counter pain relief such as ibuprofen may be used, but avoid aspirin as it thins the blood and will impair healing.
Other factors
Avoid exercise and laborious tasks for at least two weeks following the procedure. This includes lifting and carrying. Your doctor will tell you when it is safe to exercise again. Swimming and SCUBA diving should be avoided for at least four weeks.
Home aftercare is essential for a quick recovery from endoscopic sinus surgery. These tips can help, but consult your doctor for further – or more case-specific – information
