Post Operative Instructions

AFTER YOUR SURGERY, YOU SHOULD LEAVE THE RECOVERY AREA WITH SOME WRITTEN INSTRUCTIONS, PLEASE FEEL FREE TO ASK THE DISCHARGE NURSE ANY QUESTIONS REGARDING YOUR POST OPERATIVE INSTRUCTIONS.

MYRINGOTOMY WITH TUBE PLACEMENT

Though commonly performed on infants and small children, the post operative care is almost the same.

Pain is usually minimal and Tylenol or Ibuprofen is adequate for pain control. If there is an active or severe infection in the middle ears at the time of the bus insertion, the patient may go home with some antibiotic drops for several days. Normal activity is usually resumed within 24 hrs as is a normal diet. It is usually advisable to keep excess water from the ears or put plugs in the ears if the patient plans on swimming. A post operative evaluation is recommended within 2-3 weeks. Most normal medications can be resumed immediately.

There may be a small amount of drainage from the ears after surgery. If it persists, please call our office for advice.

The tubes placed in the ear drums usually stay in place for about 9 months and extrude on their own.

ADENOIDECTOMY

Though performed under a brief general anesthesia, the recovery is brief. Pain is minimal and treated with Tylenol or Ibuprofen and may be present for 24 hours. A bedside humidifier may help with the recovery. A soft diet is recommended for 24 hours and activity should be limited for 24-48 hours. A small amount of nasal discharge may be noted for a day or so. A post operative evaluation is recommended within 7-10 days

TONSILLECTOMY

The surgery usually takes about 15-20 minutes under general anesthesia and most patients are discharged to home within 2 hours. The pain and discomfort can last from 5-8 days with some days being better than others. It is really important to stay well hydrated with water or Gatorade type drinks. For 8 days we recommend a soft diet ONLY, of such things like popsicles Jello, oatmeal, ice cream/milk shakes, mashed potatoes, pasta, and slurpees. Smoothies are also great. Try to avoid citrus juices, sodas or hot beverages. Avoid spicy foods also.

We recommend a light non strenuous activity level, staying home from work or school for at least a week. Children should be supervised. We do not recommend travel for 10 days.

A humidifier at the bedside helps keep the throat moist. Pain control is typically required with narcotic medications for up to a week. Sometimes Chloraseptic mouth spray can help with break through pain, using 1-2 sprays only at a time. Nausea is rare, and patients may go home with anti nausea medications. Avoid any aspirin containing medications!

If there is any bleeding, call the office immediately (303-795-5587) or go to the nearest Emergency Room at a hospital. Most neighborhood urge care centers may not be familiar with this surgery.

Bad breath is common during the recovery phase and will slowly resolve, Avoid any gargles as they will burn terribly and can cause some bleeding. A low grade temperature is normal, if it stays over 100 degrees, pleases call the office. Ear pain is common also and intermittent. It is due to a phenomena known as “referred pain” due tho the throat irritation.

A post op visit is recommended within 7-9 days.

SEPTOPLASTY WITH OR WITHOUT TURBINATE SURGERY

This surgery usually takes 30-35 minutes with general anesthesia and most patients are discharged to home within 90 minutes of recovery.

Diet should be advanced to regular as tolerated. Activity level can be increased to non strenuous and avoid heavy lifting  for 7 days. Keep the head elevated and sleep with a few pillows. Avoid work or school for 3-5 days, especially if taking narcotic pain medications. Avoid any sports or activity where your nose may get bumped or hit.

Pain control usually requires some prescription medications for a few days, then OTC Ibuprofen may be adequate. Most patients will be discharged with some antibiotics for up to a week. Saline sprays are very helpful and recommended in each nostril 4-6 times a day as a gentle rinse. It is important so avoid nose blowing if you need to sneeze, please do so with the mouth open.

There are some soft plastic splints in each nostril supporting the repaired septum and they will need to stay in place for about a week. The nose will feel stuffy at times and an OTC decongestant might help. Antihistamines are recommended if you have bad allergies. You may want to GENTLY clean the nostrils with a Qtip periodically.

A post operative visit is recommended within 7-8 days to have the splints removed in the office, which takes only minute or so. Nasal rinses and sprays should be continued for several weeks.

TURBINATE REDUCTION (SMR)

This surgery takes lest than 10 minutes and most patients are discharged within 60 minutes. You should keep the head elevated for 3 days, sleeping with a few pillows. Non strenuous activity is recommended for 7 days. Avoid heavy lifting of > 10 lbs for 5 days. Nasal congestion is common for about a week and there may be some discharge from the nostrils for about a week, which may have some blood tinge to it.

Pain and discomfort can be managed with Ibuprofen or Tylenol. Sometimes prescription medications may be necessary. Saline sprays and moisture are important to the healing process. Avoid nose blowing for 3 days then do it GENTLY. Antihistamines are important if there is a lot of sneezing. Decongestants can help with the congestion. Avoid any aspirin containing products for a week.

If there is any bleeding or fever >100 degrees, you should call the office (303-795-5587). Post operative visit should be scheduled within 7-10 days.

SINUS SURGERY (MAXILLARY, ETHMOID, FRONTAL, SPHENOID)

Depending on which sinuses or being taken care of, this surgery can take 30-90 minutes and patients are typically discharged to home from the recovery area within 90 minutes. There may be some packing in the nasal/sinus area that will dissolve in a few days.

There is usually some nasal congestion for a week or so as the sinuses heal as well as some nasal discharge which may have some blood tinge to it. A mild headache is common as is some post nasal discharge.

You may have some prescription pain medication and antibiotics to go home with. Avoid any aspirin containing products for a week. Advance the diet as tolerated and call the office if you notice any nausea.

Nasal saline sprays and moisture are important to help promote the healing. The sprays should be started the day after surgery and down 4-6 times a day for 3 weeks. Nasal decongestant sprays such as Afrin or Neosynephrine can be used for a few days (no more than 3) for congestion. Hold off on any nasal rinses for a week. Non strenuous activity is recommended for 1 week and avoid work/school/sports for a week. Keep the head elevated at all times and avoid nose blowing for 3 days, then do it very GENTLY.

It is normal to notice some discharge and post nasal drip. If there is frank bleeding, high fevers (>101), visual changes or intense headaches, then call the office right away or go to the nearest Emergency Department.

A post operative visit is recommended within 7-10 days.

NECK SURGERIES

We often perform surgeries for neck masses or lesions that involve incisions around the face and neck, such as Thyroid surgery, Salivary Gland masses, neck masses and skin lesions. Most of these surgeries are done under general anesthesia and can be done as  an outpatient or inpatient. The details and plans for these operations will be discussed at great length when they are scheduled.

A drain may be placed in the incision area to remove any fluids such as blood or serum that can retard the healing process. Please make sure the drain is secure and stays dry. It is a good idea to record the amount of fluid in the drain. The drain can be removed in the office after 1-3 days.

Incisions generally should be kept dry and covered with a bandage for protection. We usually recommend OTC antibiotic ointment such as Neosporin or Bacitracin a few times day.

If there are stitches, they are usually removed in 5-8 days.

We recommend avoiding strenuous activities such as working out or running, but a nice long walk is a good idea. Avoid stretching  or scratching the incision area. Please call the office immediately if the incision area become red or tender or the drainage becomes excessive.