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Endoscopic Sinus Surgery

Preparing For Surgery

Thursday, March 22, 2012 - 12:20

Contributing Author: Guy Slowik FRCS

Prior to endoscopic sinus surgery, your doctor may recommend that you do the following:

  • Discontinue taking any pain relievers that contain aspirin for at least two weeks prior to surgery, as aspirin thins the blood and promotes bleeding.
  • Make an appointment for lab tests two days before surgery (depending upon the doctor's request).
  • Discontinue taking any other medications the day of surgery.
  • Do not drink or eat anything after midnight the night before surgery.

What Happens During The Procedure?

The surgery itself lasts 60 to 90 minutes, after which the patient spends an hour or two in a recovery room.

After the doctor has determined the nature of the problem and where it is located, a surgical plan will be made. A simple clearing of the intersection between the two sides of the nose is often all that is needed to relieve symptoms. In this case, a local anesthetic, where the patient remains awake during the procedure, is enough. Some crunching sounds may be heard and a sensation of tightness may be felt during the surgery, but there is no pain.

If there are several blockages deeper in the sinuses or polyps to be removed, a general anesthetic, where the patient is fully asleep, is recommended. The doctor typically begins by clearing the ethmoid sinuses, followed by the sphenoid sinuses, the frontal sinuses, and finally the maxillary sinuses, if necessary.

The doctor will clear any blockages, create larger openings where needed, correct a deviated septum if necessary, and remove any growths such as polyps.

What Happens After Surgery?

  • Someone will need to drive the patient home, since both local and general anesthesia can cause drowsiness and disorientation for a short period of time after surgery.
  • The nose is usually covered with a gauze dressing that will need to be changed whenever it becomes dirty or wet.
  • A packing is placed in the nose after surgery, which requires breathing through the mouth for a short time during the healing process. The packing usually has to be worn for only a few days, and the doctor will advise when it can be removed. It may have a bad odor, however, or cause bad breath.
  • Nose blowing should be avoided entirely for at least a week after surgery.
  • Sleep on at least two pillows to keep the head elevated.
  • It is not uncommon to experience discomfort in the nose and face for a short time after surgery. Mild headaches are also normal.
  • Do not take pain relievers containing aspirin without consulting a doctor. Aspirin can promote bleeding and cause problems after surgery.
  • Keep the nose as free from dry crusting as possible. A saline spray may be used six to eight times per day to keep the nose moist. Sometimes, the doctor will want to take care of cleaning the area in the office two to three times a week. Generally, however, the patient can make a nasal rinse from 1/4 teaspoon salt, 1/4 teaspoon baking soda, and eight ounces of warm water. A bulb syringe can then be used to squirt the solution into the nostrils whenever necessary.
  • Keep activities to a minimum for a couple of weeks, as too much activity can increase the chances of bleeding.
  • Do not lift heavy objects, swim, scuba dive, or fly for a few weeks following surgery.
  • Avoid caffeine, alcoholic beverages, spicy foods, and antihistamine medications, which can cause drying of the sinus passages.
  • Do not use decongestant nasal sprays unless prescribed by a doctor, as these sprays can become addictive after a few days of continuous use.
  • Avoid eating dairy products, which can promote excess mucus production.
  • Avoid anything that causes allergic reactions.
  • Do not smoke, and avoid secondhand smoke.
  • Drink plenty of fluids, especially water.
  • Use a humidifier, if necessary, to moisten dry air.
  • Finish all prescribed antibiotic medication.
  • Within a week after surgery, the doctor will set an appointment to check the progress of healing.

What Is The Recovery Period?

Breathing usually returns to normal within 30 to 60 days after surgery. This, of course, is a gradual process and varies from person to person.

It is recommended that individuals stay home from work or school for about a week, to rest and allow the body to heal as fast as possible.

Sometimes, the doctor will prescribe medications after surgery such as steroids or antibiotics, especially if polyps have been removed.

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