Surgery for sinus disease is a regular part of our Ear, Nose and Throat practice.
Mr Russell will have discussed the reasons for the operation. There will be evidence of acute and/or chronic sinusitis, which has become resistant to conservative medical treatment.
Admission to the hospital 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 surgery will be tailored to the individual problem, as explained by Mr Russell.
The affected area is approached with the use of telescopes and precise instruments.
Any bleeding during the operation will be stopped before the completion of the surgery, sometimes with the use of gentle packing.
AFTER THE OPERATION
There will be some nasal discomfort and, usually, a headache which is relieved by analgesics (Paracetamol). It is not uncommon for a small amount of bleeding but this settles quickly.
A nasal pack will have been placed if it was felt necessary at the end of the operation.
Surgery will have been advised because of the effect illness may have on your health.
As with all operations, there are potential problems that may arise.
Bleeding is a potential risk in most forms of sinus surgery. On occasion significant bleeding may require termination of the procedure and the placement of nasal packing. Bleeding following surgery may also require the placement of packing and hospital admission.
Some bloody post-nasal discharge may occur for approximately two weeks after this procedure. This is normal and slowly improves.
The location of the sinuses between the eyes gives the potential for injury during the surgery. If the bony wall, which protects the eye, is damaged, there may be bleeding into the eye with the possibility of temporary or permanent visual problems. Adequate preparation of the nose, clear visualisation and careful technique results in this risk being extremely small.
Spinal Fluid Leak
All operations on the ethmoid sinus carry a rare chance of creating a leak of spinal fluid (the fluid that surrounds the brain). Should this rare complication occur, it creates a potential pathway for infection, which could result in meningitis. If a spinal fluid leak should occur, it would extend your hospitalisation and might require further surgery for its closure, should it not close spontaneously. The use of endoscopes allows improved visualisation and therefore should reduce the risk of this complication.
Failure to cure the problem or recurrent disease
It is possible that the disease may not be cured by the operation or that recurrent disease may occur at a later time. In this case, subsequent medical or surgical therapy might be required.
Tearing of the eye can occasionally result from sinus surgery or inflammation and may be persistent.
Numbness or discomfort in the upper front teeth may occur for a period of time after some procedures. Occasionally some swelling, bruising or temporary numbness of the lip, or swelling or bruising of the area around the eye may occur. Blowing your nose aggressively in the early post-operative period might result in a temporary collection of air under the skin and facial swelling for a period of time. Decreased sense of smell is also a possibility.
Problems may arise with the anaesthetic if it is associated with a recent cold or chest infection, or if there is an allergy to medications. It is important to answer any questions asked by medical staff accurately as this may prevent serious trouble.
COMMONLY ASKED QUESTIONS
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.
Can I blow my nose?
Gentle nose blowing is suggested after discharge home. 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.
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. To assist the recovery, please follow these instructions.
1. There may be sinus headache. Treatment with simple painkillers 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). If you feel bleeding from the nose is excessive, contact Mr Russell.
3. Once at home commence the nasal irrigation with the product provided. This will moisten and loosen crusting and allow more rapid recovery. This can be used often each day.
5. Mouth dryness can be overcome with the use of "Aquae Mouth Spray", (made by Hamilton)
6. Stay off work for 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 cannot take them, contact the surgery.
12. It may take three to four weeks (or even longer for extensive disease) for the nose to completely settle post-operatively. After this time, the symptoms for which the procedure was performed should be gone. If they recur, return to Mr Russell, particularly in the case of any yellow or green discharge.
13. It may be felt that the progress is not steady, some days are better than others. This is quite normal. If concerned, please contact Mr Russell directly.