Endoscopic Sinus Surgery Home Care Instructions
The purpose of Endoscopic Sinus Surgery is to open the natural drainage pathways of the sinuses and widen narrow passages so mucous can drain normally from the sinuses to the nose.
The doctor inserts a nasal endoscope through the natural opening of the nose. An endoscope is a thin, flexible, narrow tube with a tiny camera on the end that allows the doctor to see the openings of your child’s sinuses on a video monitor while the doctor operates. The doctor enlarges the natural opening of the sinus by removing polyps, cysts, or thickened mucous membranes.
Having the operation:
- Endoscopic sinus surgery usually takes between one to three hours and is done in the operating room. Your child will receive medicine (anesthesia) to allow him/her to sleep through the procedure.
- Most children will stay for two to four hours after the surgery but some may stay overnight, depending on how they do in the recovery room.
- Another surgery may be done at the same time, such as septoplasty, tonsillectomy, adenoidectomy, tonsillectomy, or insertion of ear tubes.
What to expect after surgery:
- Your child will have intravenous (IV) fluids until time for discharge. Clear liquids will be given to your child in the Post Anesthesia Care Unit (PACU).
- Your child may complain of a sore nose, not being able to breathe through the nose, and difficulty swallowing.
- A non-aspirin pain reliever or a narcotic may be given for pain. Be sure to check all medication labels carefully. Acetaminophen (Tylenol) may be combined with some prescription narcotics. If so, giving your child additional acetaminophen could result in acetaminophen overdose. An antibiotic is often prescribed if there is a sinus infection.
- The head of the bed will be raised in the PACU to help with swelling, breathing, and drainage. At home you can help your child stay comfortable with his/her head elevated above the level of the chest using a recliner chair or pillows as needed.
- There is usually no packing in the nose. However, if there is packing in the nose, it is dissolvable most of the time. If the packing is not dissolvable, the doctor will remove the packing at about one week after surgery in the office.
- If a septoplasty (straightening of the bone and cartilage in the center of the nose) is performed, splints are rarely placed inside the nose at the end of the operation. However, if splints are placed, they will be removed at the doctor's office in one to two weeks and may cause some discomfort while they are in the nose.
- If packing is used, your child may be able to feel it in his/her nose (it takes a little getting used to). Your child should be told before surgery that they may feel like they have something in their nose when he/she wakes up. If packing is not used, swelling may cause this feeling. Your child should know that he/she will not be allowed to forcefully blow his/her nose for a week.
- At first, there may be some drainage from the nose and you may see a small piece of gauze taped under your child's nose. This is called a "drip pad". This is usually only needed for the first day, if at all. The drainage from the nose will probably be tinged with blood. Your child may cough or spit up some pink or brown mucous.
- Most children are fussy the first few hours after this procedure. Parents are invited into the PACU soon after the child begins to awaken.
- Your child may begin normal play after several days, but may need to stay out of school until the discomfort improves.
- Your doctor may recommend the use of nasal ointment, salt water spray, or nasal steroid spray after surgery. Follow instructions carefully.
When to call your child’s doctor:
- If your child has bright red bleeding from the nose or mouth
- If your child has double vision or impaired vision
- If your child has a persistent leak of clear fluid from the nose
- If your child vomits a lot of bright red blood
- If your child begins having a croupy (barky) cough/cry or wheezing
- If your child's temperature is greater than 101.5o rectally or greater than 100.5o by mouth. Slight fevers after surgery are normal.
- If your child has vomiting that lasts more than six hours or if the vomiting is severe. Your child's nurse will discuss this with you before you go home.
- If there are signs of dehydration. A child can become dehydrated when he/she has prolonged or severe vomiting and is not able to drink enough fluid to keep up with the loss.
Signs of dehydration
- Dry mouth
- Decreased amount of urine, which means fewer wet diapers than usual in an infant.
- Sunken look around eyes
- No tears when crying
A visit with the doctor will be scheduled for one to two weeks after surgery. Your child will need to visit the doctor several more times in the months after surgery to make sure that the nose is healing properly. Please call if you have questions. Use the phone number the nurse gives you to make the first appointment.
Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.