OK, so I'm going to have surgery - I believe he said ethmoidectomy and antrostomies. I've read previous consults here about what the surgery involves. My question is, what will life be like immediately post-op? I know "it depends," but can you give me a ballpark idea? I'm only congested on one side, and have no pain, just ear blockage, nose blockage, and trouble smelling & tasting.
How much work will I miss? What will my energy level be like? Will I have black eyes? Bruising? Facial swelling? How often will I go back to the Dr. afterward for de-crustation? :)
Also, is general anesthesia really the only practical choice? What is that recovery like?
THANKS!
Reply: ---------------------------
Endoscopic sinus surgery is generally associated with relatively less morbidity than with older forms of sinus surgery. The surgery is done with telescopes passed through the nostrils and is designed to improve the ventilation and drainage of the sinuses essentially by enlarging the normal drainage pathways. It is commonly done under local anesthesia with sedation or it can be done under general anesthesia. Either way, the procedure is done as an outpatient. Having the surgery under local anesthesia with intravenous sedation usually results in a shorter period of recovery in the hospital since there is less risk of post-operative nausea and vomiting from anesthetics. Although having the surgery under local anesthesia with sedation can be done comfortably for the patient, many patients nevertheless prefer general anesthesia. Newer general anesthetics and medications have allowed for less problems with nausea and vomiting post-operatively.
After surgery, there may or may not be packing in the nasal passages. If packing is used, it is generally removed after 24 hours. After that you can expect occasional bloody discharge from the nose which can variably last for up to a week or so. This is typically associated with dryness and crusting which can last for 2-3 weeks. Your surgeon will most likely emphasize the use of nasal saline to keep the passages moist and will instruct you to avoid strenuous activities and nose-blowing for 1-2 weeks to avoid bleeding. While there is some discomfort, it is usually related to being stuffy and irritation from dry crusts. It is generally speaking not a very painful recovery period - most of the pain may occur in the form of a headache. Most surgeons will have you return weekly for a variable period of time after surgery to clean the sinus cavities - in my experience this usually requires 2-3 visits until the sinus cavities are healing satisfactorily to allow for longer intervals between visits until complete healing has occured which may take several additional weeks, although symptoms during this later period are usually minimal.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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