Nasal & Sinus Disorders

Nasal & Sinus Resources

ENT Sinus & Surgeons of Poughkeepsie New York Common questions about nasal & sinus surgery
ENT Sinus & Surgeons of Poughkeepsie New York Nasal Steroid Sprays
ENT Sinus & Surgeons of Poughkeepsie New York Systemic Oral Steroids
ENT Sinus & Surgeons of Poughkeepsie New York Possible Risks & Complications related to Endoscopic Sinus Surgery
ENT Sinus & Surgeons of Poughkeepsie New York Endoscopic Sinus Surgery-Pre Operative Instructions
ENT Sinus & Surgeons of Poughkeepsie New York Post Operative Instructions on Endoscopic Sinus Surgery, Nasal Septum & Turbinates
ENT Sinus & Surgeons of Poughkeepsie New York Post Operative Nasal Surgery


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Endoscopic Sinus Surgery - Pre-Operative Instructions:

Sinus surgery is used to open blocked sinuses, drain the sinus passages and allow the infection to gradually resolve. There are new techniques available for sinus surgery, which cause less swelling, bruising, bleeding, and pain than before. Please review the following carefully to ensure that you do your part towards a recovery that is as uncomplicated as possible.

DON'T EAT OR DRINK AFTER MIDNIGHT THE NIGHT BEFORE SURGERY

  • DON'T - take aspirin Ibuprofen, or any other nonsteroidal anti-inflammatory drugs. Please check with your doctor to find out how much time needs to pass between the surgery and the last time you had an aspirin or any other anti-inflammatory medication.
  • The morning of your surgery PLEASE make sure you take all scheduled medication including- high blood pressure or heart medication. HOWEVER only have a SIP of water. DO NOT drink a lot of water. Your stomach is to be empty for the surgery.
  • DO - Discuss with your primary care doctor what to do about insulin or other diabetes medication.

Again if you have any questions, please speak with your Doctor.


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Post Operative Instructions on Endoscopic Sinus Surgery, Nasal Septum & Turbinates

Now that your surgery has been completed, you will begin the postoperative care phase of your treatment. Following these guidelines is important in assuring that you have a successful outcome.

It is normal to have some bleeding for several days following surgery. The nasal tip dressing should be worn to catch any bloody drainage and should be changed as needed. You may remove the dressing when there is no further bloody discharge.

Do not blow your nose for one week following surgery. After one week you may blow your nose very gently. If you have to sneeze or cough, do so through your mouth while it is open.

Begin using saline nasal sprays every 2-3 hours during the day to keep your nose and sinuses moist. This will ensure proper healing and help wash out any blood clots or crusts. You should continue this until your doctor gives further instructions.

Take only Tylenol or pain medication prescribed by your surgeon. Avoid aspirin and ibuprofen containing products. Also avoid blood thinners, vitamins, homeopathic and herbal supplements.

We recommend taking a dose of your prescribed pain medication 1 hour before your first office visit following surgery. Do not drive if you are taking a narcotic pain medication.

If you are prescribed antibiotics, these may cause gastrointestinal upset in some patients. Eating active culture yogurt may help to alleviate these symptoms. If you develop severe diarrhea, stop the antibiotics and call our office.

If you are prescribed prednisone, carefully follow the dosing schedule as prescribed.

Please refrain from all strenuous activity for at least two weeks, including bending, lifting heavy objects, or straining. You may begin light exercise (e.g. walking) one week after surgery.

Several weeks after your surgery you may notice some dark brown nasal discharge. This represents old blood and mucus being cleared from the sinuses and is normal. It does not represent a sinus infection.

Make an appointment to see the doctor 7-10 days after surgery. Anticipate frequent return visits to our office for sinus cleanings over the next 4-6 weeks or until appropriate healing of the sinuses can be assured.

Call our office as soon as possible if you experience any of the following:

  • Persistent fever above 101F
  • Profuse clear salty drainage from the nose
  • Any visual changes or marked swelling around the eyes
  • Severe headache or stiff neck
  • Severe diarrhea
  • Persistent brisk bleeding

Download Post Operative Instructions on Endoscopic Sinus Surgery, Nasal Septum & Turbinates


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Possible Risks & Complications related to Endoscopic Sinus Surgery

All surgical procedures have risks, benefits, alternatives, limitations and complication. The following risks and complications have been discussed with the patient regarding this surgical procedure include:

Other alternatives have been discussed with the patient and he/she has agreed to this procedure.

  • Bleeding- mild to moderate bleeding is expected up to 48 hours after surgery, significant bleeding may require placement of nasal packing or on rare occasions require control of bleeding in the operating room
    Infection
  • Injury to tear duct or sac resulting in tearing of the eyes. This may require further surgery
  • Need for frequent post-surgical visits for cleaning, to help prevent the disease from returning
  • External scar if an external incision is needed
  • Drainage of brain spinal fluid from the nose may occur. Further surgery may be needed.
  • Numbness of the teeth/cheek or near any external cuts or if an oral incision is needed
  • Reactions to anesthesia
  • Blindness or near vision changes. The patient should call the office immediately if vision changes after surgery.
  • Meningitis (Brain infection)- Symptoms include neck stiffness and pain, fever and headache.
  • Voice changes due to airflow changes between the nose and mouth.
  • Change in sense of smell and/or taste.
  • Unexpected cardiac, pulmonary or kidney changes from anesthesia or medications given during surgery.
  • Need for future medical (antibiotics) and surgical care.

Download PDF on Risks & Complications related to Endoscopic Sinus Surgery


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Post-Operative Nasal Surgery

For the first two (2) weeks after surgery

The Do's The Do Not's

 

  • Sleep with your head up using 3 to 4 pillows.
  • Avoid all products containing aspirin or ibuprofen.

 

  • Do not blow your nose. Sniff up and spit out if necessary
  • Do not use your nose to sneeze. Open your mouth and sneeze.
  • Do not do extreme exercise or exertion.
  • Do not bend over for long periods of time.
  • Do not drink alcohol.
  • Do not eat or drink very hot foods and/or beverages.

Irrigation

  • Make sure to follow these steps in the order specified.
  • Irrigate your nasal passages with a saline solution with bulb syringe 3 to 4 times a day. (Saline solution can be made by mixing 2 to 3 teaspoons of salt in a quart of water).
  • After 10 minutes use 2 to 3 squirts of saline antibiotic nasal spray* (as prescribed) in each nostril 3 to 4 times a day.
  • Use one squirt of Polysporin nasal ointment in each nostril after completing step 2.

Medications

  • Be sure to take your antibiotics as prescribed.
  • Take your pain medication as necessary. (Usually NO more than 3 to 4 times a day.)
  • Note: Some bloody oozing from the nose is not unusual. This will get less each day.
    Any loss of smell or taste should return in a few weeks.


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Nasal Steroid Sprays

Steroid nasal sprays are prescribed for swelling of the lining of the nose (rhinitis) and/or sinuses (sinusitis) which may be due to smoking, allergies or infection. Symptoms may include runny nose, sneezing, itching, and difficulty breathing through the nose, post-nasal drip or pressure and sinus headaches. Both rhinitis and sinusitis can worsen your ear problem by causing swelling around the Eustachian tube that drains the ear into the back of the nose. Treating these problems can be just as important as the direct treatment of your ear condition.

The steroids contained in nasal spays are very low dose and fortunately, they do not cause the severe side effects associated with prolonged use of steroids that are injected or taken orally.

Use your nasal steroid spray at the same time(s) everyday to get into a routine. Shake the bottle and remove the cover. Blow your nose to remove secretions and then use the spray as explained in the package directions. It may make you sneeze. Some of the spray may go back down the back of your throat but is not harmful. Some patients note a bad taste or mild burning – these are only temporary and not worrisome. Other side effects include dryness of the nose, crusting or slight bleeding. If these occur, apply Vaseline or Polysporin ointment to the inside of your nose twice a day and use a humidifier. See your doctor if you experience a severe nosebleed, recurrent nosebleeds, or severe sore throat.

It may take a week to notice the benefits of using a nasal steroid spray and the full effect may take 2 to 3 weeks to occur. If there as been no improvement after 3 to 4 weeks, stop the spray and see the doctor. Other medications can be tried, or a consult with an allergist or sinus specialist can be arranged if necessary.

Although some patients use these sprays for years without problems, we recommend that you stop using the spray in 2 to 3 months to “give your nose a rest”. It can be started if your symptoms return. Some patients use the spray only at certain times of the year when their rhinitis or sinusitis acts up. Others find that after a period of regular use, they only need to use their spray every other day.

We hope you find this information helpful. Speak with your doctor or pharmacist if you have any questions we might be able to help you with.

Download PDF Nasal Steroid Sprays


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Systemic Oral Steroids

Introduction and Dosing

Steroids are a type of hormone made by our bodies. Certain types of steroids are used for medical problems including arthritis, asthma and rashes. They can also be used to treat diseases related to the Ears, Nose & Throat, such as: nasal polyps, swelling of the aero digestive tract, some forms of hearing loss, dizziness and when oral steroids are taken, the body’s natural production of steroids decreases. If oral steroids are discontinued suddenly, the body may not have sufficient time to respond and increase its natural steroid production back up to the normal rate. Therefore, your steroid prescription is written so that you will slowly decrease your daily steroid dose (i.e. tapering) prior to stopping completely. It is recommended that you take your steroids on a full stomach after breakfast in the morning. This will help to prevent possible side effects such as stomach irritation and insomnia.

It is not infrequent to have some increased appetite or to retain some fluid when you are on oral steroid therapy. You should therefore watch your diet. An initial high dose may also make you feel hyperactive, and you may feel somewhat down as the dose is decreased. However, with appropriate management of the steroid dosage, these effects can usually be minimized.

If you are on oral steroids for long periods of time, it will be necessary for you to increase your steroid dose (steroid boost) if you develop a significant infection. Your doctor will inform you how to do this. Patients on long term steroids should also increase their dose if they have surgery or are involved in a major accident. Some patients may, therefore, wish to wear a medic-alert bracelet. Finally, individuals at risk for osteoporosis, especially women who have undergone menopause, should have a bone density study performed every 1-2 years if they are on long term steroids. An annual ophthalmologic (eye) examination is also recommended. In general, systemic steroids should be avoided during pregnancy or if you have a history of a bleeding abnormality, tuberculosis (TB), glaucoma, significant clinical depression, or an immune deficiency. If you have a history of a duodenal ulcer, you should inform your doctor and he will prescribe some medication to protect your stomach.

Adverse Effects
Cataracts, glaucoma, high-blood pressure, high blood sugar (as with diabetes), mood changes, insomnia, stomach irritation, nausea, ulcer disease, bone-thinning (osteoporosis) and menstrual irregularities may occur with oral steroid use. Thus, if you have a history of any of these problems, be sure to inform your doctor.

A serious but very rare adverse reaction to oral steroids (avascular necrosis) can result in permanent damage to an affected joint. Fortunately, this is very uncommon. However, you should inform your physician if you develop significant joint pains while taking oral steroids. Do not stop your steroid medication suddenly without consulting your physician. If you take other medications, check with your family doctor or your pharmacist to make sure there are no unusual drug interactions.

We hope you find this information helpful. Ask your pharmacist for an instruction brochure. Please contact our office if you have any questions.

Download PDF on Systemic Oral Steroids

 


ENT Sinus Surgery Doctors in near Poughkeepsie New York
Common Questions About Nasal & Sinus Surgery

Allergies

Nose

Sinuses

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