Post-Operative Instructions: Functional Endoscopic Sinus surgery

INDICATIONS:

• FESS is performed when medical treatment has failed to clear chronic sinus infections, eradicate intranasal and sinus polyps, to correct anatomical abnormalities that may predispose to recurrent infection, or to remove intra-sinus growths both benign and malignant.
• Evidence for the need of surgical intervention is often obtained by imaging the sinus areas through CT scanning.
• Image guided FESS (surgery assisted by a computerized visual navigation system) may be used for difficult cases with unusual anatomy, extensive sinus involvement, revisional surgery, or for surgery on difficult to manage areas of the sinuses, such as, but not limited to, the frontal sinus.
• FESS may be combined with other surgeries such as nasal septal reconstruction or blocked access to the sinus area.

WHAT TO EXPECT:

• A feeling of pressure and discomfort in the nasal area is to be expected.
• Some bleeding should be expected post operatively. A moustache dressing will be taped under your nose to catch any oozing. Change it as often as needed.
• The first 12 to 18 hours after surgery seems to be the time of most discomfort.
• Your nose will feel congested until the swelling inside subsides about one to two weeks after surgery.

ACTIVITY:

• Avoid strenuous activity: lifting, bending, straining, or vigorous exercising for 2 weeks.
• No blowing your nose for one week after surgery and then resume gently.
• If you need to sneeze, do it with your mouth open to prevent nasal irritation.
• The first night keep your head elevated—the higher the better. Sleeping in a recliner can help. Then keep your head elevated 30 degrees for the first week after surgery.
• Use a cool-mist humidifier at your bedside to help moisturize membranes in your nose and mouth.
• Avoid any travel requiring rapid elevation changes, i.e., airline or mountain travel for 4-6 weeks.
• Use saline spray to keep membranes moist and free of crusts. Use hourly while awake. Begin the day of surgery.
• Irrigate your nose twice a day with the buffered saline solution. Begin the day after your surgery.

DIET:

• In the immediate post-operative period start with clear liquids. If there is no nausea you may advance your diet as tolerated.
• Maintain an adequate fluid intake throughout the post-surgical period.

MEDICATIONS:

• Pain medication will be prescribed, as well as a Nasal spray. Take as directed at the proper interval.
• Take antibiotics as directed. Begin taking them the day before surgery.
• Apply Polysporin Ointment four times a day with a q-tip just inside the nasal openings.
• Avoid aspirin or ibuprofen, or similar medications for three weeks after surgery.

REASONS TO CONTACT DOCTOR:

• Excessive bleeding or fever, rash or diarrhea (signs of toxic shock syndrome).
• Noticeable swelling around either eye or decreased vision.
• For follow-up appointment if one was not made pre-operatively.
• Do not hesitate to contact Dr. AKhan for advise.



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