Care of the nose following septoplasty and /or turbinoplasty surgery

 

Following septoplasty and / or turbinoplasty surgery it is normal to spend one night in hospital and be placed on intravenous antibiotics for that night following the surgery. Usually a dressing is placed in either side of the nose and therefore the nose will feel blocked for that first post-operative night. This can be somewhat uncomfortable and cause the mouth to feel dry, the eyes to water and pain or discomfort in the nose and forehead. Medication will be provided in hospital to alleviate any pain. The dressing is dissolvable and salt water spray will be prescribed to help dissolve. You may notice that your swallowing some thick and sludgy material. This is just dissolved cellulose dressing material coming down from the back of the nose and is digestible (although it doesn't taste very nice!). Any residual dressing will be aspirated for the nose at the time of the first post-operative visit in the week following surgery.

 

Patients are usually discharged from hospital the morning of the day after surgery. It is recommended that patient's rest at home for four days following this type of nasal surgery before returning to work.. It is common to have a slightly sore throat for a few days following surgery due to the use of an endotracheal tube at the time of the operation by the anaesthesiologist. If a work certificate is required simply contact my office and one will be forwarded to you. Patients should not occupations that involve vigourous activity or heavy lifting for two weeks after surgery.

 

Patients are usually discharged on an oral antibiotics such as keflex which is taken for five days after surgery. They are also prescribed a nasal cream called nasalate if a septoplasty operation has been done. This is used twice a day for 10 days after surgery and is available over the counter at the chemist. A dollop of cream is placed on a cotton bud and this is rolled gently approximately 1 cm inside each nostril concentrating on the middle wall of the nose. After septoplasty surgery there are small sutures inside the nose that will dissolve. Patients are placed on a nasal saline spray such as FESS saline spray which is available over the counter at the chemist. Patients can use the spray as often as they like but typically six sprays three times a day each side of the nose would be an acceptable minimum.

 

The nose will often feel somewhat blocked for a couple of weeks after surgery. There may be some bloodstained mucus discharge and crusting. The top lip may be a little swollen for a few days and it is useful to sleep a little head up for the first week or so after surgery with the head on a couple of pillows.

 

In general nose blowing should be avoided for about two weeks after surgery. Likewise heavy activity such as heavy lifting or exercise should also be avoided for two weeks. In general a post-operative appointment is made for 7 to 10 days will after surgery. At the time of his appointment the nose will be inspected and if necessary cleaned. It is usually possible to commence gentle blowing of the no se thereafter. Patients should not fly in an aeroplane or travel to a remote area where they do not have access to hospital facilities for at least three weeks after surgery.

 

The main concern in complication following surgery is that of bleeding which may occur anything up to 2 weeks after surgery and can be exacerbated by heavy activity. Paracetamol and codeine-based analgesia is recommended (eg Panadol or Panadeine / Panadeine Forte ) after this sort of surgery and non-steroidal anti-inflammatory medications such as Aspirin and nurofen should be avoided as these can precipitate bleeding. If a nose bleed occurs the patient should sit up and place a bag of frozen peas over the bridge of their nose to cool the area. The patient can press gently with tissues under their nose which can again arrest bleeding. If this does not settle the bleeding after 15 minutes or so then a nasal decongestant spray such as drixine should be used with one spray in each side of the nose. If this arrests the bleeding in the patient should again avoid strenuous activity and use the drixine every eight hours for three days with one spray in each side of the nose. If bleeding persists despite these measures or is profuse the patient should present to the Sutherland hospital accident and emergency Department if they are in the shire or to their local hospital accident and emergency department. The doctors there and get in touch with Doctor Bridger.

 

The Royal Australian College of surgeons information brochure on septoplasty and surgery to reduce enlarged turbinates will have been given to you prior to surgery and provide additional useful information on post-operative care.