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For many sinus procedures, the post operative examinations and cleanings are essential to a successful outcome. During sinus surgery, openings are made into the sinus cavities. There is a window of time when things heal, or as I like to think of it, "harden". If you can get the sinus openings and configurations to "harden" in the right shape, they will usually work well for life. The sinus openings that are created during surgery will always become somewhat smaller as they heal. If examinations suggest that they will become too small to achieve the goal of improved drainage, then simple measures in the office can correct things during the immediate post-operative period.
One way that the sinuses can heal incorrectly is when crusts of dried blood remain in the cavities. These crusts can act like bridges and permit the mucous membranes to heal across gaps that they were not intended to cross. By cleaning these crusts post operatively, the healing process becomes more predictable, quicker, and more likely to achieve the surgical goals.
A common post operative visit begins with a simple nasal exam. If this is the first post-op visit, the amount of cleaning will depend on what was done and how sensitive things are. The nasal passage will be numbed with a lidocaine and neo-synephrine solution. This is either sprayed in the nose or soaked on cotton balls that are placed in the nose.
Once the nasal passage is decongested and numbed, an endoscopic exam may be performed. If everything looks good and is healing well, the exam is terminated and a return visit is scheduled.
Occasionally a good bit of cleaning is needed. In most cases, cleaning crusts and material out of post-operative sinus cavities is not very painful. On a rare occaision in adults, and routinely in children, post operative cleaning can be done under anesthesia.
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