Nasal and Sinus Surgery

Why have nasal and/or sinus surgery?

Nasal surgery may include septoplasty, inferior nasal turbinate reduction, or more complex repair of nasal anatomy. These types of nasal surgery are typically performed in an effort to improve nasal airflow and nasal breathing.

Sinus surgery is typically performed in an effort to improve chronic and recurrent sinus infections, and in some instances, to remove polyps or other growths in the sinus cavities.

The Procedure:

Nasal and sinus surgery may be performed as either an outpatient or an inpatient procedure and can take anywhere from 45 minutes to several hours to complete, depending on the circumstances and specifics of the planned surgery. Following the procedure, your child may remain at the hospital for several hours or overnight if admitted.

Pre-operative Instructions and Restrictions:

In the days preceding surgery, your child may take acetaminophen (Tylenol, Tempra, and Panadol), prescribed antibiotics, or an over the counter cold medicine as long as it does not contain aspirin or ibuprofen. Please notify your doctor if there is a family history of bleeding tendencies or if you child tends to bruise easily.

The following should not be ingested within 14 days of your child's surgical date:

  • Aspirin (including Pepto-Bismol)
  • Ginkgo Biloba
  • St. John's Wort
  • Omega-3 fatty acids (fish oil)

The following should not be ingested within 7 days of your child's surgical date:

  • Anti-inflammatory medications (Naproxyn, Aleve, Celebrex, etc.)
  • Ibuprofen products (Children's Motrin, Children's Advil, etc.)

Postoperative Care Instructions:

Drainage: Bloody mucous drainage can be expected for up to one week after surgery. You may wish to tape a gauze bandage beneath your child's nose for a few days. Your child should not blow his/her nose immediately after surgery, as this may cause bleeding. After 3 days, your child may blow his/her nose gently if necessary.

Cleaning your nose: Saline irrigations are the most effective way to clear the nose of mucous and dried blood. Beginning the day after surgery, the nose may be irrigated at least twice a day with a salt water solution, using a Neil med Sinus Rinse system or bulb syringe. If you do not already have a bulb syringe or Neil med Sinus Rinse bottle, they can be found at most pharmacies.

Follow the manufacturer's instructions for the Neil med Sinus Rinse system using half the bottle for each nostril.

For the bulb syringe:

  • Fill a glass with 8 ounces of lukewarm distilled water and a teaspoon of salt. Pickling salt or kosher salt works best as they do not contain anticaking additives.
  • Fill the bulb syringe with the solution.
  • While leaning over the sink, place the tip of the syringe into the nostril and gently squeeze the bulb.
  • If done correctly, mucous or dried blood will be flushed out the front of the nose.
  • Irrigate each nostril with one syringe full of salt water. Irrigations can be done vigorously, so long as they do not cause new bleeding.

At first, irrigations may feel unusual, but most children eventually find them comforting and soothing. This may be done more than twice a day, as needed.

Pain: Pain is usually mild and readily controlled by medication. An antibiotic and pain medication will likely be prescribed by your physician. Sleeping with the head elevated on at least two pillows helps to decrease pain and swelling. Do not take products containing aspirin or ibuprofen for the next week, as these may cause bleeding.

Activity: During the week following surgery, your child should avoid heavy lifting, straining, and exercise that might cause nasal bleeding. These activities may be gradually resumed after one week, as tolerated. Your child may return to full activity after two weeks. It is not uncommon for a child to need more sleep than usual during the recovery period.

When to call a physician:

  • Brisk, new bleeding that does not stop after fifteen minutes of sitting up and squeezing the nostrils together.
  • An oral temperature of greater than 101 degrees.

Healing: Do not be alarmed if at first your child has difficulty breathing through his or her nose. It typically takes 2 to 3 weeks for inflammation and swelling to subside.