What to Expect After Endoscopic Sinus Surgery: Bleeding

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Endoscopic Sinus Surgery Postoperative Instructions

Melinda Thacker, MD

What to Expect After Endoscopic Sinus Surgery:

  • Bleeding:  It is normal to have some bloody discharge for the first 3-5 days after sinus surgery, especially after you irrigate your sinuses.  If steady bleeding occurs, gently squeeze the soft part of the nose for 10 minutes. The bleeding is often coming from the septal incision just inside the nose, and application of pressure will stop it.  If bleeding persists, use 2 sprays of over the counter Afrin every 5 minutes until the bleeding slows. If both of these measures fail, call our office immediately. It is okay to blow the nose nice and gentle.

  • Pain:  You should expect some nasal and sinus pressure and pain for the first several days after surgery.  This may feel like a sinus infection or a dull ache in your sinuses.  Extra-strength Tylenol is usually all that is needed for mild post-operative discomfort. You should avoid aspirin and NSAIDs such as Motrin, Advil, and Aleve. If Tylenol is not sufficient to control the pain, you should use the post-operative pain medication prescribed to you. 

  • Fatigue:  You can expect to feel very tired for the first week.  This is normal and most patients plan on taking at least 1 week off of work to recover.  Every patient is different and some return to work sooner.

  • Nasal congestion and discharge:  You will have nasal congestion and discharge for the first few weeks.  Your nasal passage and breathing should return to normal 2-3 weeks after surgery.

  • Postoperative visits:  You can expect to follow-up in clinic 3 weeks and then 1 month after surgery.  During these visits we will clean your nose and sinuses of fluid and blood left behind.  These visits are very important to aid the healing process so it is essential that you attend all those scheduled for you.  There is some discomfort involved with the cleaning so it is best to take a pain medication (described above) 45 minutes before your visit.

What to Avoid After Endoscopic Sinus Surgery:

  • Straining:  You should avoid straining and avoid lifting anything heavier than a gallon of milk. You can resume 50% of your regular exercise regimen at 1 week after surgery and your normal routine 2 weeks after surgery. You may blow the nose very gently, not aggressively.

  • Aspirin or Non-steroidal Anti-inflammatory (NSAIDs) medications:  Aspirin and NSAIDs such as Motrin, Advil, and Aleve should be stopped 2 weeks prior to surgery.  Aspirin and NSAIDs such may cause bleeding and should be avoided for 2 weeks after surgery.

  • Steroid Nasal Sprays:  If you were taking nasal steroid sprays prior to surgery you should avoid using these for at least 2 weeks after sinus surgery to allow the lining of the nose and sinuses to heal. 

Postoperative Care Instructions:

  • Nasal Saline Spray: Nasal saline mist spray can be used every 2-3 hours after surgery and can make your nose more comfortable.  These sprays (Ayr, Ocean, Simple Saline) are over-the-counter medications and can be purchased in any pharmacy.

  • Sinus Irrigations:  You will start washing your nose with a Neil Med sinus irrigation kit 3 days after surgery.  This must be performed at least twice daily.  At first the irrigations will feel strange if you haven’t done them before.  Soon, however, they will become quite soothing as they clean out the debris left behind in your sinuses after surgery.  It is normal to have some bloody discharge with the irrigations for the first few days.  These irrigations are critical for success after sinus surgery!

When to Call After Surgery:

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