Instructions Following Sinus Surgery (ethmoidectomy, antrostomy, sphenoidotomy, frontal recess exploration)

The important thing to remember about sinus surgery is that we open the sinuses surgically and wait for the body to then clear the infection. The beneficial effects of surgery may not be realized for several weeks afterwards.

What to expect:

1. If you have packing, it may be in the sinus only, or filling the nose if your turbinates were also reduced. If it is filling the nose: 

  • You will be wearing a gauze dressing under the nose. You may need to change it hourly, because of saturation with blood and/or mucus.
  • You will be breathing through your mouth. Keep your mouth moist by drinking fluids. Small sips will be easier, since big gulps have a tendency to bother the packed nose 
  • Sleep (if you can at all) sitting up; this makes mouth breathing easier and decreases bleeding.

2. If the pack is only in the sinuses:

  • Your nose is not completely blocked. Treat your nose as if there were no packing (below). 
  • We will remove the sinus pack on ___________. Call if you do not yet have an appointment.

3. If there is no packing:

  • You will have some blood and mucus draining from your nose and down your throat. 
  • Your nose will get very stuffy after all the medications wear off. You can use Afrin® nasal spray ONCE DAILY ONLY to help you get to sleep.
  • It will take several days to two weeks before you will be noticing the improvement from your surgery.

4. We will see you at week one, then at 2-week intervals to clean the nose endoscopically, removing crusts as needed to ensure good sinus drainage.

What you can do to promote healing:

  • Once the packing is out, use the saline/Bactroban® spray prescribed to help keep the nose clear of mucus and crusts. You may sniff to help clear the nose.
  • Avoid blowing your nose hard, though gentle blowing is OK once the bleeding has stopped.
  • Avoid heavy lifting or any sports where your nose might get hit. 
  • After a week, it will be helpful to use a sinus rinse kit to remove dried blood and mucous from the nose. We can provide this kit for you at your 1 week post-op visit.

When to call us:

  • If your nose is bleeding heavily and doesn’t respond to a couple of sprays of Afrin® nasal spray
  • If you get totally blocked after the packing is out, especially if the pain seems to be getting worse, there is fever or the nose is looking more swollen.

Your prescriptions:

  • Vicodin ES #15 - take one every 4 hours for pain 
  • Levaquin 500mg #5 - take one daily 
  • Prednisone, 10mg #25 tabs: Take 2 pills every morning with food for one week. Take one pill every morning with food the second week. For the third week, take one pill in the morning every other day
  • Bactroban Nasal Ointment: #15 gm
    INSTRUCTIONS (to be mixed by the patient or the pharmacist):
    1. Empty 5 grams of ointment into a 45 ml bottle of Ocean® Nasal Spray.
    2. Warm for 20 seconds in the microwave and recap, shaking to mix
    3. Use this solution, 2 sprays in each nostril, 4 times a day.

Follow-up:

  • Call the office to make an appointment to be seen _____________.

Call me if you have any questions at all regarding your surgery or the healing process at (508)-540-0900.