I underwent a septoplasty and turbinectomy(non-laser) back in August. As I was about to leave the hospital, it was discovered that I had lost a large amount of blood. The blood was being lost down the back of my throat into my stomach, but because I wasn't complaining or vomitting it took quite awhile before anyone knew there was a problem. I was rushed back into surgery to have a special packing put in and then spent the next six days in the hospital(in considerable pain). The doctor explained that very rarely a person has a vein or blood vessel located where there normally isn't one and that because he cannot actually see what he is doing, but is rather going by feel, there was no way for him know during surgery what had happened.
This was thirteen weeks ago, and I'm still seeing my doctor as I've not fully recovered(still crusting on the right side), and now I'm going back in (tomorrow) for surgery to correct what the doctor called a "sneakyeye"(no idea how to spell) on the left side. It's a webbing that's forming in the sinus and he is going to remove it with a laser.
How rare is what I'm going thru and is there anything else I should know? I don't think my doctor is at fault, but I would feel better if someone else could confirm this.
Thankyou for any comments you might have.
Reply: ---------------------
Your post-operative course is not a typical one for turbinate surgery. I suspect that most otolaryngologists are now performing turbinate reduction surgery with a laser since bleeding can be significantly reduced. Actual excisional techniques are sometimes necessary for patients who have large turbinate bones, but in my experience, most of the time enlargement of turbinates is related to soft tissue hypertrophy. Soft tissue hypertrophy of the turbinates is a very common cause of nasal airway obstruction. The majority of patients with nasal obstruction due to large turbinates can be treated effectively with medication such as topical nasal steroids (Rhinocort, Nasacort, Flonase, etc.) and/or decongestants. When medical therapy is unsuccessful, surgical therapy is generally recommended and is usually highly successful. Turbinate reduction surgery performed with a laser is generally associated with little bleeding. However crusting is a very common post-operative occurrence necessitating frequent use of nasal saline and nasal emollients. It is also frequently necessary to return to the surgeon's office on a couple of occasions following surgery for debridement of crusts in the initial several weeks following surgery. Keep in mind, the main purpose of the turbinates is to warm and humidify the air flowing through the nose. Excessive removal of the turbinates can result in a condition known as atrophic rhinitis associated with chronic dryness and crusting. This is the main risk of turbinate reduction surgery but fortunately this complication is remote with carefully performed surgery and diligent post-operative care.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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