What to Expect After Sinus Surgery-Sinus Surgery Recovery

Dr. K. R. Meghanadh

What happens after sinus surgery?

Following sinus surgery, patients are monitored in the ICU for four hours. If the patient recovers quickly, the doctor may transfer them to a regular room early. After the anesthesia wears off, the patient may feel drowsy for around 30 minutes. It is usual for patients to experience some discomfort and swelling in the nasal region after sinusitis surgery since doctors usually place a pack or dressing inside the nose for one to five days following the operation.

How long does it take for a patient to recover from sinus surgery?

Sinus surgery recovery will take 1 to 5 days. The patient must breathe through their mouth due to the nose pack during this time, which may cause discomfort. In some cases, nasal dressing or nose pack can be avoided, allowing the patient to breathe through their nose, although this situation is rare. Usually, different protocols exist regarding the duration of nasal dressing. Some surgeons recommend keeping it for 24 hours, while others prefer to leave it for 1 to 5 days. Each has its own advantages and disadvantages. Generally, Dr. K. Raja Meghanadh prefers to leave the nasal dressing for five days.

According to him, it provides more significant benefits. During the five days after surgery, the patient may feel discomfort from the nasal dressing, but it should not be painful. However, leaving the dressing in for the full five days is essential for achieving 90% healing in the desired direction. Suppose the dressing is removed after only 24 hours. In that case, the healing process becomes unpredictable, and the skin edges may not bind together as desired.

In surgery, the skin is cut, and the healing process involves binding the skin edges to create a single continuous layer. The placement and duration of the dressing or pack used during surgery affect the direction in which the skin edges heal. Therefore, keeping the dressing in place for five days can sometimes be crucial to achieving predictable healing in the desired direction. Although the patient may experience discomfort during this time, it ultimately leads to a more successful healing outcome.

What not to do after sinus surgery?

Following sinus surgery, it is important to follow post-operative instructions provided by your doctor, as these may vary depending on the type of sinus surgery you had and your individual needs. However, there are some general guidelines on what not to do after sinus surgery:

1. Avoid blowing your nose forcefully, particularly by closing one nostril and blowing heavily. Such actions can exert pressure on the veins and lead to bleeding. It can even cause complications like middle ear infections.

2. Avoid doing strenuous exercise and lifting weights that are heavier than 10 kg.

3. Avoid straining while passing stools.

4. Do not bend or keep your head down below the level of your heart.

Engaging in the activities mentioned earlier can exert pressure on veins, which may result in bleeding. The human circulatory system consists of two types of blood vessels: the high-pressure and low-pressure systems. Arteries are part of the high-pressure system, carrying blood away from the heart to the rest of the body under high pressure. Veins are part of the low-pressure system, and they carry blood from different parts of the body back to the heart under low pressure.

Arteries have thick walls to withstand high pressure, while veins have thinner walls since they operate under lower pressure. When pressure increases on veins, such as during activities that strain the body, their thin walls may rupture, leading to bleeding. Therefore, it is essential to avoid the actions that we mentioned. These actions increase pressure on the veins and result in bleeding.

It is important to note that post-operative care instructions may vary depending on the surgeon, type of surgery, and hospital protocol. So, it is crucial to adhere to the specific guidelines provided by your surgeon. The above guidelines are general guidelines that should be followed after sinus surgery.

What causes a nosebleed after sinus surgery?

In our hospital, cases of nosebleeds after sinus surgery are rare, occurring only in 1 out of 1000 cases. This happens when an individual fails to follow the abovementioned steps. So, following the recommended steps is essential to decrease the likelihood of experiencing bleeding.

Three types of nosebleeds can occur after sinus surgery: primary hemorrhage, reactionary hemorrhage, and secondary hemorrhage.

Primary hemorrhage

Primary hemorrhage is the bleeding that can occur during the surgery. It is supposed to be controlled by the surgeon as a part of the surgery using proper surgical techniques.

Reactionary hemorrhage

Reactionary hemorrhage refers to bleeding within 24 to 48 hours after removing the dressing. This can be caused by the opening of a previously closed blood vessel. In such cases, we take the patient to the operation theatre to identify and block the bleeding vessel. If the bleeding is from arteries, we will follow this procedure. But if it's from veins, we gently pack the nose to control the bleeding.

Secondary hemorrhage

If the bleeding happens after 5 to 10 days of pack removal, it is called secondary hemorrhage. This type of bleeding usually occurs due to an infection that antibiotics have not effectively treated. This may happen when the patient misses doses of the medication when the antibiotics cannot enter the blood, or when the intestines do not absorb them properly. In such cases, the patient is admitted to the hospital and given intravenous antibiotics.

What medication is given after sinus surgery?

Antibiotics

Following sinus surgery, doctors will prescribe antibiotics based on the type of infection. Usually, The antibiotics are given for 3 to 5 days in IV form. But if the infection is severe, treatment may extend up to 10 days. If there are any complications, doctors may extend the course of antibiotics to 7 to 10 days. Once the initial course of IV antibiotics is completed, doctors will prescribe oral antibiotics for the remaining recovery period. The duration of oral antibiotics may vary depending on the individual surgeon's preferences. Some may prescribe a shorter course of antibiotics for ten days, while others may prescribe a milder antibiotic for up to 45 days. We usually prescribe milder antibiotics for 45 days.

Anti-allergic medication

In addition to antibiotics, doctors may also prescribe supportive medications such as anti-allergies following sinus surgery. Usually, anti-allergic medications are given in case of allergies, and most patients will have allergies, so we give allergic medicines.

Nasal irrigation after sinus surgery

Nasal irrigations are used to remove the gel that is applied during surgery. Typically, nasal irrigation is initiated 72 hours to six days after the surgery. For nasal irrigation, we will take sterile water with an appropriate quantity of sodium chloride and other steroid medication to wash your nose. This process is similar to Jal neti pot, but sterile water is used instead of plain water. Usually, many people use plain water while using a jal neti pot, but we should never use plain water. We have to add some salt, i.e., for 500ml of water, we need to add 5 grams of salt. The water should be distilled or sterile, which we can buy from a store or make at home. To make sterile water, add 1 liter of water to a pressure cooker and let it boil until you hear 2 to 3 whistles. Once the water has cooled to a lukewarm temperature, add the salt. By following this process, we can make water for nasal irrigation.

Why do I need pain meds after sinus surgery?

Post-surgery, doctors prescribe pain relief medication to reduce swelling more than pain. As the swelling slows healing, we give this medication to control the swelling. This medication is generally given for 7 to 10 days. It helps in the healing process by decreasing the swelling of the sinuses resulting from surgery and pre-existing swelling. As swelling can hinder healing, anti-inflammatory medication is given to minimize swelling and discomfort. Such medication has two actions: analgesic, which reduces pain. And anti-inflammatory, which curtails the burning sensation within the sinus lining.

How long do symptoms last after sinus surgery?

The symptoms will subside gradually over 45 days after the surgery. However, Within the first 48 hours, around 90% of the symptoms are expected to improve. The remaining 10% of the symptoms will subside within 45 days of the surgery. It is common for some patients to experience fatigue after the surgery. This is usually because of anesthesia given during the surgery, which wears off within 2 hours and not beyond that.

Daily life after sinus surgery

Usually, patients can resume their daily chores after three days of sinus surgery, while returning to work may take up to five days. But it depends on the type of work and individual recovery rate. Those working from home may resume work as early as 48 hours after the surgery. When it comes to eating, it is advised to eat slowly, as there will be dressing in the nose, due to which we have to breathe through the mouth while consuming. Nevertheless, apart from this, patients can resume their usual activities without any issues. But following the post-operative instructions and attending follow-up appointments is crucial.

Written by

Dr. K. R. Meghanadh

FAQs

Can I blow my nose after sinus surgery?

No, you should not blow your nose after sinus surgery. Doing so can create pressure that might cause bleeding and delay the healing process. It's essential to follow post-operative instructions closely to avoid complications and ensure a smooth recovery. Always consult with your surgeon for any specific concerns or instructions related to your specific procedure.