Post Operative Advice

After a Septoplasty and/or Turbinoplasty, the main problem is a degree of bleeding and crusting. You should flush the nose with a saline washer twice a day until this settles. You will be given some pads to wear under the nose to catch dripping blood to protect your clothing and bedlinen. You can blow your nose gently. Temporary use of a decongestant such as Iliadin or Drixine may help for post op congestion. If there is increasing pain or severe bleeding, please call me urgently.

A certain amount of minor bleeding is normal as the sinuses are not packed with a pressure dressing. Rather a small amount of dissolvable gel is used to help with bleeding and healing. A pad is worn under the nose to catch the drips and protect clothing and bed linen.

Antibiotics are given to prevent post- op infection.

After sinus surgery, crusts and scabs form on the new fresh sinus surfaces. It is therefore a good idea to rinse twice a day with a saline solution to get rid of these to encourage healing and to prevent excess scar tissue from forming.

You should continue to use a steroid nasal spray if this is prescribed.

Don’t blow your nose too hard, as this may force air into the tissue around the eyes.

Call me if there is significant bleeding or sudden swelling around the eyes.

Most recovery takes place in the first 10 days, but full recovery of the sinuses takes about 6 weeks. Increasing pain or a bad smell and discharge may mean an infection, and you should come in to see me.

Your child should hear very much better after the surgery if there was a glue ear. Balance may also improve.

Slight bleeding from the ear is not unusual, and is not a cause for concern. The ears are not usually very painful afterwards.

If an adenoidectomy was done together with the surgery, there may be some throat pain, requiring painkillers for 3-4 days.

If a discharge develops from the ear, this usually means that there is a slight infection, and we can treat it with antibiotic drops down the ear canal. Call me if you suspect that this is the case.

Most children don’t need ear plugs, but if your child can’t be dissuaded from swimming to the bottom of the pool, or if getting pool water into the ears hurts or causes infections, I would recommend swimming ear plugs.

You will wake up with a plug in the ear, but there may still be some minor oozing of blood. You can tape a piece of cotton wool over this to soak it up.

If there is any other sort of discharge, or pain or pressure, not responding to painkillers, please contact me urgently.

You may well have ringing in the ear (tinnitus) temporarily after the surgery as the ear will be blocked, which should resolve after the packing is removed at 10 days post-op.

You will then be given antibiotics and steroid ear drops to prevent infection. I will see you every week to 2 weeks afterward to clean the ear of crusts.

Keep the ear dry (no watersport) for 2 weeks post-op.

In the future, always wear earplugs and possibly a hoodie, to prevent the regrowth of the bony ear canal exostoses.

The balance organs of the two ears work together, sending equal impulses to the brain. They are essential for the maintenance of
balance of the head and body. Damage to one of the balance centres causes vertigo or dizziness, which is often accompanied by
unsteadiness, nausea, and vomiting. Although this condition may be very frightening, it is not usually serious or life-threatening.

The purpose of the exercises is to build up a tolerance mechanism in the brain that compensates for the imbalance between the
two ears. Frequent repetition of the exercises will usually lead to more rapid improvement in the dizziness and impaired balance.

The exercises should be carried out persistently for a total of at least 5 minutes, 3 times daily, and for as long as the symptoms
persist. This may be for up to 3 months.

You should not try to perform all the exercises at once. Rather, you should perform a group of exercises at a time, starting at the
top of the list. You should concentrate on performing only the exercises that cause dizziness. When you can perform a particular
section of exercises without feeling dizzy, you should proceed to the next group down the page.

Certain medications may be taken to control any nausea during the initial stages of the exercise therapy, but prolonged use of
these medications should be avoided.

Early return to exercise and sporting activities is also an important part of treatment.

Sitting

1. Eye movements—at first slowly, then quickly:
   • up and down
   • from side to side
   • focus on finger with arm extended and slowly move finger
   • towards face until vision starts to blur.
2. Head movements—at first slowly, then quickly (later with eyes closed):
   • bend forward and backward
   • turn from side to side.
3. Bend forward and pick up objects from the ground.

Standing

1. Follow steps 1 to 3 described above while standing.
2. Change from sitting to standing position with eyes open and shut.
3. Throw a small ball from hand to hand (above eye level).
4. Change from sitting to a standing position and make a full turn in between.

Moving about

1. Circle around a centre person who will throw a ball back and forth.
2. Walk across a room with eyes open and then closed.
3. Walk up and down a slope with eyes open and then closed.
4. Walk up and down steps with eyes open and then closed.
5. Any game involving bending, stretching and aiming such as tennis, bowls or basketball.