Nasal Surgery

 

Surgery of the nose is a regular part of  our Ear, Nose and Throat practice.

 

Mr Russell will have discussed the reasons for the operation. Nasal obstruction and nasal deformity are the two most common reasons for undergoing a nose operation. Nasal obstruction may often be relieved by medications (sprays) and surgery will be advised if these treatments have not been successful. Before any cosmetic operation (rhinoplasty) it is important to have medical photographs taken of the nose. This will have been arranged.

 

Admission will be on the day of surgery. Once in hospital, the routine admission procedures will take place, involving interviews with nursing staff. This will provide information necessary for your comfort and medical care.

 

The anaesthetist will visit to explain the form of anaesthetic to be used. A nasal spray may be applied to prepare the nose for surgery.

 

The trip to the operating theatre will be with a nurse, ending by meeting one of the operating room nurses, and the anaesthetist. The anaesthetist will then commence the anaesthetic using the method that was explained previously.

 

 

THE OPERATION

 

The surgery will be tailored to the individual problem, as explained by Mr Russell.

 

Most nasal surgery is performed within the nose without external incisions.

 

Any bleeding during the operation will be stopped before the completion of the surgery, sometimes with the use of a gentle pack. Dissolvable sutures are frequently used.

 

AFTER THE OPERATION

 

There will be nasal discomfort and, usually, a headache that is relieved by analgesics (Paracetamol). It is not uncommon for a small amount of bleeding but this settles quickly. Rhinoplasty surgery frequently involves re-breaking the nasal bones. This will cause some swelling and bruising around the eyes and cheeks.

 

A nasal pack will have been placed if it was felt necessary at the end of the operation. This will be left to dissolve with time.

 

An external dressing (and plaster) may be used for Rhinoplasty surgery. This will remain for up to one week.

 

COMPLICATIONS

 

The decision to undergo nasal surgery must be considered in light of the potential problems that may arise.

 

Bleeding

Bleeding is a potential risk in most forms of nasal surgery. If troublesome at the completion of the operation packing will be placed in the nose. Bleeding following discharge may also require the placement of packing and hospital admission. Blood transfusion is very rarely required.

 

Post-Operative Discharge

Some bloody post-nasal discharge may occur for approximately two weeks after this procedure. This is normal and slowly improves.

 

Persistent Airway Problems

On occasions, the planned improvement in the airway does not arise. The cartilage and bone of the nose may resist any change in position and scarring may pull the septum back into the pre-operative position. In this situation further surgery may be possible.

 

Unfavourable Cosmetic Result

Rhinoplasty surgery involves changing the external appearance of the nose. The final result will only be apparent many months after the operation. On occasions there may be the need for a second operation to fine-tune the first procedure. This may be a planned approach and will be discussed pre-operatively.

 

COMMONLY ASKED QUESTIONS

 

Can I blow my nose?

Once commencing nasal irrigation on the first day home, nose blowing is allowed. After this time gentle clearance will aid in healing and remove discomfort. If blowing the nose is painful or causes bleeding or facial swelling, cease and contact Mr Russell.

 

When will I be able to return to work?

Return to strenuous exercise or work is NOT recommended for at least one week. Your energy will be lacking and there is a risk of bleeding before healing. In the second week, there should be a slow build up towards normal activity.

 

Do I really need this operation?

There are generally alternative treatments for all illnesses, however if surgery is suggested, it will be because other methods have not been, or would not be effective. If the decision is being reconsidered, please discuss this with Mr Russell.

 

 

DISCHARGE INSTRUCTIONS

 

It will take you approx. TWO WEEKS to fully recover from this operation. Your nose will be uncomfortable for two to three days post-operatively (longer for Rhinoplasty). To assist the recovery, please follow these instructions.

 

1. There may be "sinus-type" headache. Treatment with simple analgesics will usually ease this. Do not take any Aspirin (or other anti-inflammatories) or alcohol for two weeks post-operatively.

 

2. There may be a blood or blood-stained mucus discharge (keep a bolster under the nose to catch these drips). You should keep quiet, sit up with ice packs applied to the outer aspect of the nose. If you feel bleeding from the nose is excessive, contact Mr Russell.

 

3. The nose can be blown from the first day, but gently. Clearing the nose will reduce discomfort and encourage healing. Vigorous, continuous blowing may cause bleeding or increased swelling in the lining of the nose.

 

4. On discharge, you will be provided with some medications, including nasal irrigations. Nasal irrigation is suggested to keep the nose clear, lessen bleeding and to keep any factors such as allergy under control while the nose is healing. Use the irrigation until advised by Mr Russell.

 

5. Mouth dryness can be overcome with the use of "Aquae Mouth Spray", (made by Hamilton)

 

6. Allow to be off work for  up to two weeks.

 

7. Keep away from irritants i.e. smoke, dusts, pollen, aerosol sprays and extremes of temperature. If you must sneeze, do so with your mouth open or again, the face or eye may swell.

 

8. Avoid people with infections.

 

9. Avoid hot baths, showers or sauna baths.

 

10. Avoid physical exertion or any activity which will overheat the body.

 

11. It is important that you take the full course of antibiotics or any other medication that has been prescribed by Mr Russell. If, for any reason you can not take them, contact the surgery.

 

12. The dressing used in Rhinoplasty will remain for up to one week until removed by Mr Russell.

 

13. It may be felt that the progress is not steady, some days being better than others. This is quite normal. If concerned, please contact Mr Russell directly. Return to Mr Russell if you develop increasing pain, discharge, bleeding or a high temperature.

 

 

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