Expectations of Sinus Surgery

Jamie Litvack, MD, MS

introduction
The majority of patients will experience significant improvement in their sinus symptoms after surgery. However, it takes time for the body to heal.  While some patients may notice dramatic improvement immediately following surgery, others may take weeks before they feel substantially better.  This depends on a number of factors including the type and extent of surgery and the patient’s personal experience. Remember, it takes time for the sinuses to fully heal after surgery.

expectations
Pain – Some patients experience minimal amounts of pain after surgery, while others may experience significant pain for several days.  Your doctor will give you a prescription for pain medication to help you control pain during your recovery from surgery.  Patients who are hesitant to use prescription pain medications may benefit from over-the-counter Tylenol.
 
Bleeding – It is common to see blood-tinged nasal secretions during the first days after surgery.  Keep your head elevated.  Avoid nose blowing. If you feel a sneeze coming, open your mouth and turn it into a cough to reduce the pressure in your nose.  Avoid strenuous exercise for the first 2 weeks after surgery. Also avoid medications that can thin your blood such as aspirin, ibuprofen, Coumadin, and some herbal medications until cleared by your doctor.  It is NOT normal to have heavy amounts of bleeding after surgery. If you have bleeding that does not stop after holding nasal pressure for several minutes or you are concerned that you are bleeding too much, call your doctor’s office immediately or go to your local emergency department for further evaluation.
 
Nasal congestion/obstruction – Some patients may notice dramatic improvement in their nasal congestion immediately after surgery, but others may not notice improvement for several days to weeks. Both of these experiences are normal. After surgery, nasal congestion may be related to a number of factors including packing, crusting and normal post-surgery swelling. Be patient, irrigate regularly, and follow up with your doctor.  It should get better.
 
Fatigue – It is common to feel tired in the first days to weeks after surgery. Remember to take it easy while your body is recovering.
 
Antibiotics – Infection is a common problem in patients with chronic sinusitis.  It is also a risk of surgery. To minimize the risk of infection, your doctor may prescribe antibiotics. The most important thing you can do after surgery to help reduce infection is regularly irrigate your nose and sinuses with saline irrigations. If you experience an infection after surgery, it can be treated with antibiotics.

Steroids - One of the underlying causes of some forms of chronic sinusitis is inflammation and swelling. To improve healing, to decrease swelling, and to treat these forms of swelling, your doctor may prescribe oral steroids or topical (spray, irrigation) steroids or both.
 
Packing – You may or may not have packing in your nose after surgery. If you have packing, it comes in two forms. One is absorbable and will dissolve on its own with time and regular saline irrigations. The other is not absorbable and will be removed by your doctor at a clinic appointment after surgery.
 
Irrigations – The most important thing you can do to help facilitate your recovery after surgery is regularly irrigate your nose and sinuses with saline irrigations after surgery. Your doctor will show you how these work. Gently hold pressure while you lean over the sink or shower. You do NOT need to push hard.  Click here for one example of how to irrigate.
 
Clinic visits after surgery – It is important to see your doctor in clinic after surgery. He or she will look in your nose with an endoscope, remove any crusts that do not flush out with saline irrigations (you may hear this referred to as “debridement”) and pull out any nonabsorbable packing. Additionally, he or she will make sure you are not scarring, healing well, and are on the road to recovery!
 
Return to work – Plan to take some time off after surgery. Some patients will be ready to go back to work in a matter of days while others will need 1-2 weeks to recover. This will depend on the extent of surgery, your recovery experience, and the nature of your work. If you have a desk job, you may be able to go back to work before the end of a week, but expect to be tired and limit your work demands. If you have a job that demands strenuous labor, you may need to take as much as 2 weeks off until your body has time to heal. Be patient. If you push yourself too hard and too fast, you may risk slowing the healing process. With time and good post-surgery care, the vast majority of patients experience significant long-term improvement!

For information about possible risks and complications of surgery, click here.
 
 

Revised 8/2011
©American Rhinologic Society