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PATIENT INFORMATION

Adenoidectomy

Post-operative Instructions:

  • Normal diet can be resumed as tolerated.

  • Adenoidectomy is not usually painful, some over-the-counter analgesia may be required for the first few days and a mild neck ache may be experienced.

  • Take any antibiotics if prescribed following surgery.

  •  Avoid exertion for the first 48 hours.


What to Expect:

  • There may be some thin bloody ooze from the nose for the first 2 days.

  • Occasionally there is a nasal change to the voice which is temporary following the removal of particularly large adenoids. Thin fluids when drunk can run from the nose temporarily in this scenario and settles over a week or so.

  • Temporary bad breath can result from the use of diathermy to control bleeding from the adenoid bed and will resolve.


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood from the nose or mouth.

  • The neck becomes stiff or sore.

  • There is any adverse reaction to prescribed medication

 
 
Ear Surgery

Post-operative Instructions:

  • Packing has been placed in the ear canal to stabilize it while it heals over the next three weeks. Please leave it in place. If it dislodges, please cut off the segment which has fallen out.

  • The ear canal should remain dry until advised that it can be wet again. Any wound behind the ear can be washed and patted dry.

  • If washing hair, please avoid getting the ear wet. The best way of achieving this is to have someone else wash the hair or go to a salon.

  • Do not fly until advised it is safe to do so.

  • Avoid heavy lifting or physical activity for 2 weeks


What to Expect:

  • A small amount of bloodstained discharge is normal and may persist for up to a week.

  • The ear will appear swollen and will stand out more until the swelling resolves in a few weeks.

  • Mild facial pain or headache is normal and best treated with over-the-counter paracetamol or ibuprofen.

  • The ear will feel quite deaf until packing is removed and the middle ear has healed.


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood from the ear.

  • Worsening pain, not controlled by over-the counter pain relief.

  • Any reactions to prescribed medications.

  • Redness, pain or swelling of the ear.

Grommets Surgery
Overview
 
Grommet surgery is a procedure that places a ventilation tube in the ear drum. This tube (or grommet) drains fluid out of the middle ear and allows ‘equalisation’ of air pressure between the outside environment and the middle ear. Grommet Surgery is a minor surgery, commonly performed in children, for recurrent ear infections or persisting middle ear fluid.
 
Laryngeal Surgery

Post-operative Instructions:

  • Voice rest is recommended. This involves not raising the voice or whispering. Speaking for short times is fine, using a normal voice.

  • Please take anti-reflux medication if prescribed, even if you do not usually experience acid reflux. Other anti-reflux measures include having a small evening meal, avoiding alcohol and not smoking. You should aim to retire to bed feeling slightly hungry.
     

What to expect:

  • Your voice may be hoarse for several weeks following surgery, with gradual improvement over that time.

  • Discomfort on the muscles of the jaw and throat, or upper teeth is common following laryngeal surgery, and should respond to simple over-the-counter pain relief.

  • It is not unusual to expectorate a small quantity of blood for a few days following surgery.
     

Contact the rooms of Mr Gordon or present to an emergency department if:

  • You have steadily worsening pain, bleeding or voice deterioration.

  • You develop noisy or difficult breathing.

  • You have any adverse reaction to prescribed medication.

 
Neck Surgery

Post-operative instructions:

  • No exertional activity for 2 weeks after surgery.

  • Keep incision lines clean with gentle washing and pat dry.

  • Use antibiotic ointment over the incision line if prescribed.

  • Take any prescribed antibiotic as directed.


What to expect:

 

  • There will be mild numbness and swelling over the operative site for 2 weeks following surgery. The area will feel firm to touch.

  • Discomfort on chewing or mouth-opening is common.

  • There may be a small amount of bloody ooze from the incision or drain sites for a few days following surgery.
     

Contact the rooms of Mr Gordon or present to an emergency department if:

  • You have steadily worsening pain, bleeding or swelling at the operative site.

  • You experience weakness of mouth or eye movement.

  • You develop a dry or irritated eye on the same side as the operation.

  • You develop a hoarse voice, or difficulty chewing or swallowing.

  • You develop difficulty breathing or noisy breathing.

  • You have any adverse reactions to prescribed medication.

 
Intra-oral Surgery

Post-operative Instructions:

  • You are free to eat anything you feel you can get down.

  • Pain is expected and is known to be severe. The worst day is usually about day five post-op. Regular paracetamol and nurofen is the mainstay of pain relief and should be taken four times per day for the first week.

  • Adequate hydration and fluid intake is more important than managing solids in the first week post-op.

  • Topical anaesthetic gel such as Bonjela can be useful for pain management if the surgical site is towards the front of the mouth or under the tongue.

  • If antibiotics are prescribed following surgery, please complete the course unless side effects are noted, in which case cease and contact Mr Gordon.

  • Stay within one hour of the hospital where your surgery was performed for 2 weeks post-operatively to allow for the possibility of a post-operative bleed.

  • Avoid heavy lifting or physical activity for ten days.


What to Expect:

  • Pain as described above.

  • A white eschar covers the surgical site and is normal. It is not pus and does not mean that there is an infection


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood from the mouth.

  • Worsening pain, not controlled by over-the counter pain relief and making oral intake impossible.

  • Any reactions to prescribed medications

 
Panendoscopy Surgery

Post op instructions:

  • Voice rest is recommended. This involves not raising the voice or whispering. Speaking for short times is fine, using a normal voice.

  • Please take anti-reflux medication if prescribed, even if you do not usually experience acid reflux. Other anti-reflux measures include having a small evening meal, avoiding alcohol and not smoking. You should aim to retire to bed feeling slightly hungry.


What to expect:

  • Your voice may be hoarse for several weeks following surgery, with gradual improvement over that time.

  • Discomfort on the muscles of the jaw and throat, or upper teeth is common following panendoscopy, and should respond to simple over-the-counter pain relief.

  • It is not unusual to expectorate a small quantity of blood for a few days following surgery.


Contact the rooms of Mr Gordon or present to an emergency department if:

  • You have steadily worsening pain, bleeding or voice deterioration.

  • You develop noisy or difficult breathing.

  • You have any adverse reaction to prescribed medication.

 
Surgery for Skin Lesions

Post-operative Instructions:

  • The dressing over the operative site consists of an antiseptic wad tied down with silk sutures. This is to keep the skin graft in contact with the underlying tissues in order to "take" over the next week. Please don't remove or interfere with this dressing and avoid wetting it.

  • The skin graft donor site is usually closed as a straight line with dissolving sutures. The dressing over this can be removed on day 3 and the suture line gently washed.

  • If on Warfarin or other blood thinners, these can be taken the day following the procedure.

  • Take any antibiotic as directed and please complete the course unless there is a serious adverse reaction.


What to Expect:

  • Mild redness and discomfort are normal and should resolve over the coming week, getting better with each day.

  • The edges of the wound can sometimes ooze a little blood, especially if Aspirin or blood-thinners are being taken.


Contact the rooms or Mr Gordon if:

  • Some redness, swelling or mild discomfort is normal but if the area develops a throbbing pain with spreading redness, or discharge of pus then it may be infected and advice should be sought.

  • The dressing over the graft is dislodged.

  • There is a dark swelling under the graft or at the donor site which looks like a raised bruise.

 
Septum and Sinus Surgery

Post-operative Instructions:

  • Avoid nose-blowing for one week following surgery until reviewed by Mr Gordon in the rooms. Do not fly for 2 weeks.

  • Sneeze with the mouth open.

  • Use a sinus rinse (atomised sprays are not sufficient) such as Nasal FLO (available over the counter in pharmacies) twice a day at least. Best used in the shower. Bend over and tilt the head to one side, allowing the fluid to wash up the uppermost nostril and drain out the lower one. Repeat for the other side. Some blood-stained material is to be expected.

  • If antibiotics or steroids are prescribed following surgery, please complete the course unless side effects are noted, in which case cease and contact Mr Gordon.

  • Avoid heavy lifting or physical activity for 2 weeks


What to Expect:

  • A small amount of bloodstained nasal discharge is normal and may persist for up to a week.

  • The nose will continue to feel blocked until all the swelling of the nasal lining resolves – often taking as much as six weeks.

  • Mild facial pain or headache is normal and best treated with over-the-counter paracetamol or ibuprofen.


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood from the nose.

  • Worsening pain, not controlled by over-the counter pain relief.

  • Any reactions to prescribed medications.

  • Redness or swelling of the eyes, nose or face.

  • Visual disturbance, severe eye pain or severe headache.

 
Stapedectomy

Post-operative Instructions:

  • Packing has been placed in the ear canal to stabilize it while it heals over the next three weeks. Please leave it in place. If it dislodges, please cut off the segment which has fallen out.

  • The ear canal should remain dry until advised that it can be wet again. Any wound behind the ear can be washed and patted dry.

  • If washing hair, please avoid getting the ear wet. The best way of achieving this is to have someone else wash the hair or go to a salon.

  • Do not fly until advised it is safe to do so.

  • Avoid heavy lifting or physical activity for 2 weeks


What to Expect:

  • A small amount of bloodstained discharge is normal and may persist for up to a week.

  • Mild facial pain or headache is normal and best treated with over-the-counter paracetamol or ibuprofen.

  • The ear will feel quite deaf until packing is removed and the middle ear has healed.


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood from the ear.

  • Worsening pain, not controlled by over-the counter pain relief.

  • Sudden onset of dizziness or hearing loss.

  • Any reactions to prescribed medications.

  • Redness, pain or swelling of the ear.

 
Tonsillectomy Surgery

Post-operative Instructions:

  • You are free to eat anything you feel you can get down.

  • Pain is expected and is known to be severe. The worst day is usually about day five post-op. Regular paracetamol and ibuprofen is the mainstay of pain relief and should be taken four times per day for the first week. Prednisone has been found to be very effective in reducing pain and stimulating appetite in children during the first five days.

  • It is of utmost importance to maintain an adequate fluid intake. Fluids are more important than solids in the early stages, especially for children.

  • If antibiotics are prescribed following surgery, please complete the course unless side effects are noted, in which case cease and contact Mr Gordon.

  • Stay within one hour of the hospital where your surgery was performed for 2 weeks post-operatively to allow for the possibility of a post-tonsillectomy bleed.

  • Avoid heavy lifting or physical activity for ten days.


What to Expect:

  • Pain as described above.

  • A white eschar covers the area where the tonsils used to be and is normal. It is not pus and does not mean that there is an infection


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood from the mouth.

  • Worsening pain, not controlled by over-the counter pain relief and making oral intake impossible.

  • Any reactions to prescribed medications.

  • Fevers

 
Removal of submandibular gland

Post-operative Instructions:

  • The wound has been closed with dissolving stitches. The dressing over the wound should be left in place until the post-operative review. Once the dressing has been removed, the wound can be washed and patted dry.

  • Take antibiotics as prescribed.

  • Avoid heavy lifting or physical activity for 2 weeks


What to Expect:

  • The area under the jaw will feel swollen and bruised for up to 2 weeks.

  • Tongue movement may feel strange for the first 2 weeks.


Contact the rooms or Mr Gordon if:

  • There is a sudden flow of fresh blood or the area under the jaw becomes suddenly swollen.

  • Worsening pain, not controlled by over-the counter pain relief.

  • Any reactions to prescribed medications.

  • Difficulty speaking or swallowing.

  • Fevers, redness, discharge of pus or difficulty breathing.

 

© 2019  Specialist ENT Care