Why is Nasal Surgery Performed?
The lining of the nose and sinuses filters the air, cleaning, warming, and humidifying the air before it reaches the lungs. The septum is a wall made of cartilage and bone that divides the two sides of the nose. There are also structures, called turbinates, that increase the surface area of the nose. Sometimes the nose becomes blocked from a bent, or deviated, septum or enlarged turbinates. The purpose of nasal surgery is to remove portions of these structures that block ventilation and air flow. This in turn prevents sinus infections and clears breathing passageways.
What Are My Instructions Before Surgery?
- Septoplasty and inferior turbinoplasty surgery is performed in the hospital as an outpatient surgery, which means you come in and go home the same day. You may arrive at the hospital by yourself, but someone must accompany you home because you will be too lethargic to get home safely on your own.
- Before surgery, you must have a physical exam by your primary care doctor. This must be done within 30 days of surgery to make sure you are in good health, and your doctor needs to complete the History and Physical form provided by our office. We must receive the completed form at least 1 week before the day of surgery. Alternatively we can arrange for you to go to presurgical testing at the hospital.
- Medicines like Motrin, Advil and Ibuprofen should be strictly avoided for 7 days before and 14 days after surgery because they decrease the body’s ability to clot blood. Tylenol is safe to take. Many over-the-counter products contain aspirin, so be sure to read labels carefully.
- You cannot eat or drink anything after midnight the night preceding surgery. An empty stomach prior to anesthesia prevents stomach contents from leaking into your breathing passages while you are asleep.
- The night before surgery someone from the hospital will call to let you know when to arrive.
On the Day of Surgery
You must arrive at the hospital at least 2 hours prior to surgery. You will be taken to the holding area where you will meet the anesthesiologist and speak with Dr. Dahl before surgery.
How is the surgery performed?
This surgery is done under general anesthesia. A small incision is made on the inside of the right nostril so the lining around the septum can be lifted. The bent portions of septal cartilage and bone are removed to make the septum straighter. Dissolvable sutures are used to close the incision and hold the remainder of the septal lining in place. A small camera is then placed inside the nose and long instruments are used to access the turbinates. The lower edge of the turbinates are cut and cauterized to create a larger nasal passageway. Nasal gauze is placed in the nose temporarily and removed when you wake from anesthesia. The biggest risks of surgery are bleeding (less than 1%), infection, and the risk of general anesthesia.
What can I expect after surgery?
When surgery is over, you are taken into the recovery room. It may take 1-2 hours for you to fully wake up. After you are drinking fluids, your IV will be removed, and you can be discharged home with your escort. You must have someone accompany you home. You will be given prescriptions for antibiotics and pain medicine.
What should I expect when I go home?
- An upset stomach and vomiting are common for the first 24 hours after surgery (due to anesthesia).
- This procedure is not very painful, but you may have a burning type pain for the first 1-2 days post op. You will be given prescriptions for antibiotics and pain medication, which you can start when you get home.
- You will not have nasal packing after surgery. However, there will be raw areas in your nose so expect bleeding and some blood clots for the first two weeks. You will need gauze pads to collect the drainage for the first few days. Your nose will also feel congested and blocked for the first 1 to 2 weeks, but it will not be bruised.
- Do not take any medicines that have not been prescribed or recommended by your doctor. Medicines like aspirin, ibuprofen, and many others will increase the risk of severe bleeding for 2 weeks after surgery. Only Tylenol is safe. If you are not sure if a medicine is safe, please call your doctor.
- You can resume normal activity as soon as you feel up to it, but you cannot perform sports or heavy exercise for the first 7-10 days. You may return to work when ready. Most patients return 3-5 days after surgery. Do not travel out of reach of your doctor before this time.
Post operative care
- Use the prescribed antibiotics starting the day after surgery. Use the pain medications as needed beginning when you get home but avoid aspirin and aspirin related products for 2 weeks.
- Use a humidifier/steam inhalation during the day (at least twice), for 15 minutes at a time for the first week.
- Irrigate your sinuses using saline sinus rinse twice a day starting the day after surgery.
- Use Afrin spray as needed for 3 days to clear nasal congestion.
- Use Neosporin on a Q-tip to clear crusting and dried blood from the nostrils.
- You can sleep with your head elevated or flat, whichever is more comfortable for you.
- You can eat or drink anything you want and shower whenever you like.
- Do not blow your nose for 2 days following surgery. You should sneeze with your mouth open if you have to sneeze.
- Do not participate in any activity which will increase the pressure in the sinuses. (i.e. bending over, lifting heavy objects, straining, working out) for one week following surgery.
- Reduce your workload. Most patients return to work 3-5 days after surgery.
- Your first post-operative visit should be 7-10 days after surgery. The second cleaning is one week after the first. During these visits your nose will be cleaned. It is somewhat uncomfortable, so you may want to take Vicodin beforehand. You will be able to breathe more clearly afterward.
- You can restart antihistamines 1 week and nasal steroid sprays 2 weeks after surgery.
- You may need more than two post-operative cleanings, depending on how you heal. The healing process is usually complete after 1 month.