Four weeks ago, I had endoscopic sinus surgery. The results have been wonderful given the fact that all sinuses were terribly diseased; surgery also involved repair of the septum.I can breathe, sleep through the night, and talk in my normal voice...three things I hadn't done for years. My recovery was phenomenal but last week I developed headaches around the forehead, cheeks, and near the nose. A return trip to the doctor uncovered some very ugly crusts, which he removed. I had been to the doctor only a week before and things looked good. On the return visit, my doctor said the sinuses are clear, somewhat inflamed, but not infected. I was put back on antibiotic and a 6-day course of cortisone. I have also begun twice-daily saline nasal irrigation, in addition to the squirts of saline spray throughout the day, to keep the passages clear. It appears that my cilia are not doing their job so I must do the irrigation to prevent all the ugly build-up and consequent problems. I'll be off the cortisone in 3 days and I still have some headaches. I'm worried that they're not going to go away. I don't want to take cortisone again and my doctor agrees. Since the surgery was only 4 weeks ago, is it common for the headaches to persist? My ENT is on vacation so I've come to you for help.
Thanks
Reply -----------------------
It is likely that you are experiencing post-operative symptoms that are within the normal range and will likely resolve with time. Following sinus surgery, it is common to accumulate dry crusts within the sinuses during the healing process. These crusts can irritate and obstruct the sinuses, occasionally leading to post-operative inflammation and superficial infections. In the vast majority of cases this responds to periodic visits to the surgeon for "cleaning" and home treatments designed to keep the sinuses moist. Irrigations of the sinuses at home are commonly prescribed for this purpose. As to your comment about the cilia, it is true that the cilia take some time to resume their normal functional activity following such sinus surgery. This period of time seems to be variable and may be influenced by the severity of disease present that necessitated the surgery. When return of normal ciliary activity is slow, the risk of post-operative infection rises. Therefore antibiotics including the use of antibiotic solutions for irrigation may be necessary after surgery. However, based upon your early post-operative experience, I would be very optimistic about a highly successful ultimate outcome.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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