NASAL SURGERY POST-OPERATIVE INSTRUCTIONS

Now that your nasal surgery is over, you should expect to feel an improvement in your symptoms as the nasal surgery area heals, and the swelling goes down. The following instructions are designed to warn you about complications, how to avoid them and how to speed up the healing process. Common nasal surgery complications include:

• Congestion
  This is a common side-effect and is to be expected. Use a decongestant nose drop, e.g. Drixine or Iliadin three times a day if the congestion is particularly bad. Sleep in a head-up position – i.e. use extra pillows. Avoid alcohol, very hot meals or drinks and smoking. Use a nasal douche regularly – see below for instructions.
• Bleeding
  A minor degree of bleeding is to be expected at intervals, but copious bleeding should be reported either to your GP or Dr. Vanlierde, particularly if the bleeding comprises fresh blood and does not stop spontaneously. It is also important to:
  • Avoid blowing your nose forcibly for two weeks.
  • Avoid drugs like aspirin, which thins the blood and prevent it from clotting.
  • Avoid lifting heavy objects and straining.
  • Do not do vigorous exercises for two weeks.
  • Do not move too far away from medical care for the first two weeks.
  • Don’t bungee jump!!!
• Scarring
  The inside of the nose can scar, causing adhesions. Old blood clots and scabs will promote scarring, cause discomfort, promote infection and encourage bleeding if they are not removed. To avoid this, complication uses the following solution as a nasal douche:
  • 1 litre of cooled boiled water, but warmed to body temperature before use
  • 1 teaspoon salt
  • ½ teaspoon bicarbonate of soda

Mix the solution together and keep it in the bathroom with a 20ml syringe handy, or a manufactured bottle as given to you post-nasal surgery. To use the solution, you can bend over a basin and syringe the fluid into the nose, aiming at the eye's outer aspect so that the solution can go into your sinuses due to gravity. After half a minute or so, sit up and let the solution drain into the bowl – you may blow.

Your husband/wife/your partner or your kids will probably find this exercise repulsive and will want to avoid you – but please persevere. You may also try sniffing this solution in the shower. You will find that long hot showers with gentle nose blowing in the shower will also feel good and be beneficial.

• Sinus Surgery
  Be aware that meningitis is a rare complication of sinus surgery. Any high fever, vomiting, severe headache, pain resulting from looking into bright lights, fits or confusion demands immediate medical attention either personally by Dr. Martin Vanlierde or by your GP. This condition is easily treated when discovered early.
• Rhinoplasty Surgery
  You can expect bruising around the eyes to last for at least a week. A daily walk will help to open the lymphatics and cut down on bruising and swelling. You can also expect the plaster cast to get a little looser as the swelling reduces over a few days. Do not wear glasses for two weeks after rhinoplasty surgery. Avoid sunlight for the first two weeks and please use factor 30 or stronger sunblock over the nose and face for one month after the rhinoplasty surgery.
  If you have had rhinoplasty you will need to start flushing your nose with saline; normally a bottle and kit will be given to you when you leave the hospital.
  If you have had an open procedure, there will be stitches on the base of the columella (the area between the two nostrils at the base of the nose). These stitches need to be kept clean by using an ear bud dipped in boiled water, or salt water to gently clean the stitches in front of a mirror to help you. This should be done twice a day until you see your surgeon in follow up. An antibiotic cream to apply to the stitches after cleaning will be supplied to you on leaving the hospital.
• Changes in Smell or Taste Changes
  This is due to congestion and should improve as the sinonasal surgery area heals. Please expect to feel tired, irritable and possibly depressed after an operation – it is, after all, a strenuous experience. Plenty of rest, fluids, healthy food and sleep will rectify the situation. The nose heals rapidly, and complications are relatively infrequent.

If you have had rhinoplasty you will need to start flushing your nose with saline; normally a bottle and kit will be given to you when you leave the hospital.

If you have had an open procedure, there will be stitches on the base of the columella (the area between the two nostrils at the base of the nose). These stitches need to be kept clean by using an ear bud dipped in boiled water, or salt water to gently clean the stitches in front of a mirror to help you. This should be done twice a day until you see your surgeon in follow up. An antibiotic cream to apply to the stitches after cleaning will be supplied to you on leaving the hospital.

Dr. Vanlierde will schedule follow up appointments every week until you have healed – the first few consultation fees are included in the fee for the sinonasal surgery. If you experience any other problems at any time, please contact Dr. Vanlierde on
082 425 8369 .

Have a speedy recovery!