Ohio Sinus Institute

Post-Op Instructions

Introduction
Although you have had the most advanced and least invasive sinus procedure available today, it is not uncommon to experience some postoperative discomfort. I have addressed the most common questions below.

General

• It is common to feel tired after general anesthesia and sinus surgery for up to 10 days postoperatively. DO NOT overdue it, increase your activity level gradually.
• Slight bleeding is expected after surgery and can last up to 10 days. Brisk bleeding that does not stop should be reported to your doctor.
• If you are experiencing a nosebleed place your head down and pinch your nostrils for 20 minutes.
• Irrigations will result in significant clots and debris being washed out of your sinus cavities.
• Clear drainage several hours after irrigations is common and will typically come out at the worst possible moments.
• Low grade temperatures are common after general anesthesia, however, if your temperature is greater than 101.5 °F, report this to your doctor.
• Patients routinely experience pain and pressure between or above the eyes.
• For patients who have also had a septoplasty, stents used in the nose make it difficult to breath until they are removed at the first postoperative visit.
• If you feel it is difficult to get air through your nose after surgery, Afrin (oxymetazoline) or Neosynephrine nasal spray can be used at night for up to 3 consecutive days. These medications are addictive and must be discontinued after 3 days.

Medications

• Your doctor will prescribe strong pain medicines (narcotics) for pain control after surgery. The majority of patients require pain relief for up to 7 days after surgery. To wean off of the narcotics, slowly substitute Tylenol for pain relief. Avoid aspirin, ibuprofen or other non-steroidal anti-inflammatoy pain relievers for 2 weeks after surgery.
• Antibiotics are not routinely prescribed after surgery unless your surgeon has identified an infection.
• Steroids are not routinely prescribed after surgery unless there is concern for swelling after surgery.

Activity and Restrictions

• Increase your activity gradually over the next two weeks.
• Running errands or light work is allowed.
• Gentle nose blowing is allowed and sneeze with your mouth open.
• You do not need to wear a mask during the recovery period.
• No heavy lifting greater than 20 lbs. for the next 2 weeks.
• No aerobic exercise until after the completion of the first postoperative visit.
• No swimming or chlorine pool exposure until 2 weeks after surgery.
• No driving or operating machinery while on the narcotic medicines.
• No flying for 2 weeks.

Salt Water Rinse for the Nose (Buffered Hypertonic Saline Nasal Irrigations)

Irrigations work by clearing out debris and crusting from the nose and sinuses. Studies show that this mixture helps the nose work better and move mucous out of the nose faster. Irrigations will prevent scar tissue from forming and decreases the amount of discomfort with the first postoperative debridement.

Start with sterile, bottled or boiled water; DO NOT USE TAP WATER. We recommend using a pure salt such as canning, pickling or kosher salt. This can be found at any grocery store. Do not use iodized table salt. Arm & Hammer standard baking soda is acceptable.

You will be provided with an irrigating 2 ounce syringe to use during the postoperative period. You may also use a water pik if cleaned with dilute bleach solution after each irrigation. We discourage the use of bulb syringes as they have been found to grow bacteria and fungi.

Irrigation Recipe:

1. Mix 2 heaping teaspoons of salt and 1 teaspoon of baking soda in a quart of bottled or boiled water. Some patients choose to mix an entire gallon using 8 teaspoons of salt with 4 teaspoons of baking soda in a gallon of bottled or boiled water. (If you experience any burning with the recommended concentration, decrease the amount of salt to 1 teaspoon per quart of water.)

Irrigation Instructions:

1. Use the irrigation syringe or water pik over the sink or in the shower (head down and mouth open) by gently placing it in the nose and using a strong spray in the nose. If done properly it will come out the other nostril and mouth. Some patients prefer to warm the solution to body temperature in the microwave prior to use.
2. Try to avoid swallowing the salt water rinse.
3. Use 4 syringefuls (8 ounces) per side three times daily. This is the minimum, if it helps keep your nose open you can irrigate more frequently.
4. Irrigations three times daily are required for the first 4 weeks after surgery, then once daily for another 4 weeks.

Postoperative Visits

• In order to obtain a satisfactory result, postoperative visits are essential. If scar tissue begins to form, this can be dealt with at your routine postoperative visits.
• Your first postoperative visit will be between days 6 and 12 after surgery. At that office visit small, soft sponge spacers will be removed from the nose along with old clots and debris. Please call the office for an appointment, (614) 771-9871.
• The second postoperative visit is 2 to 3 weeks after the surgery and requires much less cleaning.
• The final scheduled visit is 6 weeks after surgery.
• Depending on the type of sinus disease, some patients require visits 3 to 4 times per year.

Recovery Period and Healing

• We routinely recommend 10 to 14 days off work and your doctor will assist you with paperwork. The majority of patients feel well enough to return to work within 7 to 10 days.
• Most patients are healed within 4 weeks.

Postoperative Medications

• Some patients may require postoperative steroid sprays to control sinus swelling.

IF YOU HAVE QUESTIONS, CALL THE OFFICE (614) 771-9871.