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Endoscopic Sinus


Endoscopic Sinus Surgery

You and your doctor have decided that your child needs sinus surgery.  The differences between medical and surgical management have been discussed.  The following information will help you understand what to expect.

The sinuses are air spaces located around the nose.  These sinuses are divided into four main areas. 

1) Ethmoid sinuses are located between the eyes. 
2) Maxillary sinuses are located in the cheek area. 
3) Frontal sinuses are located in the forehead.
4) Sphenoid sinuses are located in the center of the head above the back of the nose.

The sinuses connect to the nasal cavity by small drainage pathways.  Abnormal structure, acute or chronic infections, or allergies may cause swelling of the nasal lining, which can lead to obstruction of the flow of drainage.  This can set the stage for an infection within the sinuses.

Factors that can contribute to sinusitis include:

  • Frequent upper respiratory infections
  • Smoking
  • Allergies
  • Gastric Reflux
  • Cystic fibrosis
  • Immune deficiencies
  • Structural defects of the nasal bones

Possible complications of surgery include:

  • Anesthesia
  • Visual loss
  • Increased tearing
  • Meningitis
  • Double vision

These complications are most unlikely.

Pre-Op Expectations

Once surgery is scheduled , only Tylenol should be given for fever or pain.  Aspirin or aspirin-like compounds ( Advil, Ibuprophen, Aleve or Naprosyn) should be avoided because they will interfere with blood clotting and may contribute to bleeding.

Home Recovery

Expect an overnight stay after the first procedure. Discharge is usually scheduled for the next morning.  The IV inserted during surgery will remain in place until your child can tolerate liquids by mouth.  Some nausea and vomiting may be expected.  This is usually caused from anesthesia or swallowing a small amount of blood.  In the post-op period there may be a thin bloody discharge from the nose.  A small guaze pad may be placed under the nose to absorb any nasal drainage.  Since surgery is performed with special scopes through the nostrils, there will be no incisions or swelling on the face.

  • Post-op discomfort is usually minimal, but Tylenol is available if needed. Use of an antibiotic and nasal spray will continue at the time of dishcarge and until further instructions.  You may give your child Tylenol every 3-4 hours to relieve discomfort.  Again, avoid aspirin or aspirin-like products for two weeks after surgery, since they maycause postoperative bleeding.
  • Nasal drainage can be expected 3-4 days postoperatively and may be blood tinged or discolored.  If needed, your child can sniff secretions, but DO NOT BLOW THE NOSE.  Your child may experience an increase of nasal stuffiness or congestion for several days after surgery.
  • Your child may return to school within 2-3 days, after surgery with limited participation in physical education, recess and sports.  You should discourage your child from swimming untill discussing it with your physician.
  • Notify your doctor immediately if your child complains of double or blurred vision, watery eyes, fever, stiff neck or significant headaches after surgery.
  • Since a second surgery is usually required to remove the stents, you can expect to have a similar experience as the first surgery, but with some minor changes.  Your child will be discharged on the day of surgery and recovery is usually faster.  Please refer to expectations after the first surgery for details.

General Information

  • Sinus surgery does not prevent your child from catching the common cold.  An average child will get 6-8 colds a year.
  • If cold symptoms persist longer than 7-10 days see your pediatrician; this may be a sinus infection that would require starting antibiotics.  If the infection does not clear in approximately 10 days, you should call our office.
  • Follow-up visits are scheduled according to the needs of each child.  The initial post-op visit after the second procedure is usually within 2-4 weeks

 

 




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