Endoscopic Sinus Surgery

This handout will tell you what to expect after endoscopic sinus surgery. This type of surgery uses a tool called an endoscope to look at your sinuses through your nose. Your doctor will then remove tissue that is blocking your sinuses to help them drain.

Sinus Drainage
Expect bright red drainage from your nose after surgery. It will decrease in amount and turn darker in color over the next few days. You may have a small amount of blood-tinged drainage for about 10 to 14 days. You will be sent home with a gauze pad under your nose. Change the pad under your nose as it becomes soiled. Pads will be sent home with you.

Packing
During surgery your doctor may put packing in your nose to prevent bleeding and scarring. Some packing will be removed at your first visit. You may take pain medicine 30 minutes before this visit, but only if someone can drive you. This may make the packing removal more comfortable.

Other packing will dissolve on its own. Your doctor will tell you about using a nasal saline mist spray or saline irrigations to help the packing dissolve. You can purchase the mist sprays (Ocean, Ayr, and Simple Saline) and sinus irrigation systems (SinuCleanse, Neti pot) at any pharmacy.

Sinus Rinses
Start using the nasal saline mist spray and the irrigation system rinses on:
Nasal saline mist: ___________________
Irrigation rinses: ____________________

You may have large crusts or scabs coming from the nose when you first start using them. This is normal. The sinus rinses are vital for healing.

Nasal Congestion
Expect your nose to be stuffy. This is caused by swelling that will decrease over the next 2-3 weeks. The stuffy feeling may last a few months as your sinuses fully heal.

Tips

• Sleep with your head raised for at least the first week (so your head is raised about 30º). This will help decrease the stuffy feeling and pressure in your nose.

• Breathe through your mouth until the packing is out and the swelling is less. This may cause some dryness and soreness of your mouth and throat. Use a humidifier or vaporizer along with good oral care.

• Do not blow your nose for 1 week after surgery or until your packing has been removed. This is to help prevent bleeding. Once you begin your sinus rinses, you will be able to gently blow your nose.

• Sneeze with your mouth open.
  Do not hold back a sneeze.

• Do not smoke. Avoid second-hand smoke and other fumes that can irritate the nose.

• If you use a steroid nasal spray, ask your doctor when you can restart it.
  

Pain
Expect some nasal sinus pressure and pain for the first few days. This may feel like a sinus infection or a dull ache. Extra-strength Tylenol® is often all you need. Avoid aspirin
and NSAIDs such as Motrin®, Advil®, and Aleve® for the first week after surgery. If Tylenol® is not enough to control the pain, use the pain medicine prescribed by your doctor. Do not drive or drink alcohol when taking narcotic pain pills.

Cold packs to your nose and sinus areas may help with pain. Apply 20 minutes at a time several times a day. Frozen peas or corn in a Ziploc® bag wrapped in a towel works well. Do not apply cold directly to your skin.

Activity Guidelines

• Only light activity for one week. No aerobics, jogging, exercising, swimming, or contact sports.

• Avoid bending over and lifting any objects over 25 pounds for 2 weeks.

• Do not travel by airplane for 3-4 weeks to avoid pressure changes and the dry airplane air.

• Avoid alcohol, coffee, and other drinks that dehydrate.
  

When to Call

• Sudden vision changes (loss of vision, double vision, or eye pain)

• Severe headache with neck stiffness

• Bleeding from the nose that is soaking through 5-6 gauze pads in less than 1 hour

• Fever of 100.5 F or higher

• Pain not relieved by medicine and rest
  

Who to Call
UW Hospital Otolaryngology (ENT) Clinic
Monday – Friday, 8 am-5 pm
(608) 263-6190 or 1 (800) 323-8942

If you saw your surgeon at:
1 S. Park Street ENT Clinic
608-287-2500
Monday-Friday, 8 am-5 pm.

After hours, weekends and holidays the clinic number is answered by the paging operator. Ask for the Otolaryngology (ENT) doctor on call. Leave your name and phone number with the area code. The doctor will call you back.