Post Operative Information

Adenoidectomy is an outpatient procedure performed under general anesthesia.  The procedure takes approximately 30 minutes and may be performed in conjunction with tonsillectomy and / or myringotomy with tubes. Surgery of the adenoids is primarily done to treat chronic ear, sinus and or throat infections, nasal obstruction, snoring and sleep apnea.

Following surgery pain medications and antibiotics are prescribed. Discomfort usually resolves within two to three days and school or work may be resumed at that time. Complete healing takes 4-6 weeks and may be accompanied by persistent drainage in the throat. Any drainage lasting longer should be brought to the attention of the surgeon as it may signify infection and require treatment. Saline nasal sprays are advised to help the healing process and should be continued until the patient feels completely healed or unless directed by the surgeon.

Bad breath and mild headaches are not uncommon complaints and usually resolve within 7-10 days. Again saline nasal sprays help limit any odor and Tylenol or Motrin suffice for the headaches.

In a small percentage (5-15%) of patients, adenoid re-growth may be seen. This is mostly true for children whose adenoids are removed before the age of three where by small nests of tissue may be embedded in the pharyngeal muscle and are not appreciated without excessive trauma to the muscle. Oftentimes if symptoms of adenoid re-growth occur the surgeon may reexamine the area with a nasal endoscope in the office to confirm or rule out any re-growth. Revision or secondary adenoidectomy may then be required.

Success rates for adenoidectomy are over 90% and benefits are seen for the vast majority of patients with chronic sinus, ear, and throat infections, or those affected by snoring and or sleep apnea. If you have any further questions please do not hesitate to contact our office to speak to your surgeon or a member of our staff.

This procedure may be performed in the office setting or operating room using local or general anesthesia depending on the age and anatomic consideration of the patient. The procedure takes 10-15 minutes depending on whether one or both ears are to be treated. It may be performed by itself or at the same setting as adenoidectomy with or without tonsillectomy, or another procedure.

Following the procedure eardrops are prescribed for three to five days and the patient should keep water out of the ear canal until cleared by the doctor.

Tubes stay in place for approximately two years and tend to come out on their own without any complication. For some patients (<5%) and depending on the nature of their ear drum and middle, the tubes may fall out earlier, or conversely stay in longer than desired.  If they fall out too early they may have to be replaced, and if they stay in too long (>30 months), your doctor may advise to have them removed, a procedure performed in the operating room.

In addition to the above-mentioned risks, rarely a tube may fall out and leave a small perforation that, if left untreated, can cause a mild hearing loss. This can be repaired usually with a minor 10-minute procedure (patch myringoplasty). It is important to have regular check ups with your surgeon to check the tube every 4-6 months to ensure proper care and treatment if necessary.  Please do not assume that your child will complain if there is a problem.

In the appropriate patient, the placement of ear tubes can help restore hearing, help with speech development in a delayed child, and limit the number of infections. They may also be performed to treat sudden deafness or an acute complication of otitis media (middle ear infections).

If you have any questions please feel free to contact our office to speak to your surgeon or member of our staff.

This minimally invasive procedure can be performed either in the office or operating room depending on the patient’s anatomy.

Single or multiple sinuses openings are expanded using a retractable balloon device to allow for better airflow and less frequent sinus infections.

Access to the sinus may be performed through the nose or via the mouth and depends on the patient’s anatomy determined by office endoscopy and CT scan without contrast.

This 30-minute procedure has a minimal recovery time requiring few if any pain medications following the procedure. Antibiotics may be prescribed starting five days before and for the five days following.

The patient should be able to return to normal function and work the following day.

Complications following balloon sinuplasty are extremely rare and like any other sinus procedure involve mild bleeding, headache and injury to the orbit.

Please do not hesitate to call our office if you have any questions or concerns to speak to a member of our staff.

Removal of part or all of the parotid gland (parotidectomy) may be performed as an outpatient or overnight stay on the hospital. Occasionally it is performed with neck dissection in the setting of certain types of cancer.

The surgery takes 2-3 hours to perform and postoperatively a drain, sutures, and a large dressing are placed. The drain is removed in 1-2 days and the dressing thereafter, and the sutures are removed in the office at approximately one week

The incision should be kept dry for approximately 48 hours after the drain is removed and a topical antibiotic ointment is recommended for one week to the incision and drain sites.

It is advised not to fly or drive for two weeks following the procedure.

Complications relating to parotidectomy include paresthesia or numbness of the lobule of the ear (most common as the sensory nerve to the ear runs over the gland and tumor), hematoma, infection, facial nerve paralysis, and gustatory sweating (Frey’s syndrome – a condition characterized by moisture of the skin over the gland while eating and/or salivating). The above-mentioned complications are all rare (<1%) and you should notify your surgeon if you experience any of these problems.

Parotidectomy is generally considered a safe surgical procedure whose benefits when indicated out weigh the risks.

If you have further questions please do not hesitate to contact our office to speak with your surgeon or other member of our staff.

Myringoplasty is an outpatient procedure to repair a small perforation of the eardrum (tympanic membrane), usually performed at the time a tube is removed in the operating room or when a tube has fallen out and left a small hole that has not healed.

The procedure is performed under local or general anesthesia, depending on the age and comfort level of the patient. During the procedure, the perforation’s edges are stimulated to grow using gentle instrumentation, and a small piece of cigarette paper or absorbable film (Epifilm) is placed over the hole. The patch acts as a scaffold for the eardrum to grow under.

The eardrum takes approximately two months to completely heal and during that time no water or medication should be placed in the ear unless directed by the surgeon. No nose blowing is advised for at least one month and flying should not be attempted until cleared by the surgeon.

The procedure requires no pain medications following and its success rate is reported anywhere from 70-90%. Failure occurs primarily due to persistent inflammation or infection of the patient’s sinuses and / or adenoids. If so further treatment of these areas may be needed before repeated attempt at repair of the eardrum, possibly in the form of tympanoplasty.

If you have any question regarding this procedure please do not hesitate to call our office to speak to your surgeon or a staff member.

Recovery following septoplasty usually lasts approximately 7-10 days. Most patients can go back to work after one week, or sooner if the patient feels well enough.  The most common complaint is congestion following the surgery and usually resolves without sequelae within one week. Patients are encouraged to use preservative free saline sprays and antibiotic ointments to promote healing. Nose blowing, heavy lifting, and air travel should be avoided for two weeks.

Patients will be prescribed antibiotics and pain medicines following surgery and should be taken as directed. If packing is placed, it is usually removed on the day following surgery. Packing is placed to help decrease bleeding and swelling, and also helps align the septum in its appropriate anatomic position.

The patient should alert their surgeon if they experience any increasing pain, headache or bleeding following surgery. The risks of complications are rare (less than 1%) following septoplasty include bleeding, septal peforation, septal hematoma and even rarer spinal fluid leak (less than 0.001%).

Greater than 95% of patients will report improved breathing through the nose following surgery. Septoplasty may also be performed in conjunction with endoscopic sinus surgery, turbinate reduction or outfracture, and cosmetic surgery of the nose (rhinoplasty).

 

Endoscopic sinus surgery is generally performed on an outpatient basis and takes approximately one hour to perform. It may be performed in conjunction with septoplasty or turbinate surgery.  In cases of chronic sinus inflammation affecting multiple sinuses, surgery should be considered part of the treatment and not solely a cure. Treatment of ongoing inflammation such as allergy and / or infection with medications and or immunotherapy is advised for best long-term outcomes.

Recovery time following sinus surgery takes approximately 3-5 days. Packing may or may not be placed depending on the patient’s condition. Antibiotics and pain medications are prescribed following. The nasal cavity takes approximately 3-4 weeks to completely heal inside and saline sprays are used to help allow for healing.

Smoking is not permitted following sinus surgery, as healing may be affected and prolonged infection and unfavorable outcomes result.

Nose blowing, heavy lifting (>10 lbs), and flying should be avoided for approximately two weeks. Driving may be resumed after 48 hours or if no further pain medications are required.

Complications following sinus surgery are rare and include but are not limited to bleeding and infection (<1%). Even rarer complications such as injury to the eye or brain, including spinal fluid and stroke have been reported in the literature (<0.001%).

Mild headache and drainage are not uncommon complaints in the weeks during the healing process following surgery and are not considered complications. They will usually resolve within three weeks and are easily managed with Tylenol or Motrin. Follow up appointments with your surgeon will ensure appropriate healing.

Post-op visits on day 1, week 1 and week 3 are given to ensure appropriate healing and understanding of post op care.

If you have any further questions please don not hesitate to contact our office, and please visit our patient testimonial section to see what our patients have to say.

Thyroidectomy is performed under general anesthesia either as an out patient or overnight stay in the hospital. Complete thyroidectomy, or single sided thyroid lobectomy may be performed for many reasons including thyroid cancer, enlarged benign nodules, swallowing and/or respiratory difficulty due to enlarged gland (goiter), chronic inflammation and autoimmune disease (Graves disease).

A 4- 6cm incision in a natural skin crease in the neck is utilized and surgery takes approximately 2-4 hours. Post operatively a drain may be placed which is usually removed the first or second day following surgery. Sutures are removed on or around day 7. Pain medications and antibiotics are utilized for up to one week following and the patient should take 7-10 days off work depending on the type of work they do. No heavy lifting, driving and/or air travel are advised for at least two weeks following surgery.

If the entire gland has been removed replacement hormone is started in the month following surgery and is coordinated with your medical doctor or endocrinologist.

Risks of surgery include but are not limited to infection, bleeding, vocal cord paralysis and hoarseness, need for further surgery, and tracheostomy tube placement (all less than 0.001%).

If you have further questions please do not hesitate to contact our office to speak to a member of our staff.

 

Tympanoplasty, with or without mastoidectomy involves surgery of the middle ear and eardrum. Surgery is performed for several possible reasons including correcting a perforated eardrum, removing infection, cholesteatoma, and or repairing the small bones of hearing (the ossicles). Mastoidectomy where by infection of the bone behind the ear is cleaned may also be required.

The procedure takes place under general anesthesia and may last any where from 1-3 hours. The surgery may be performed directly through the ear canal or through an incision behind the ear. The ear canal is packed with an absorbable material which is dissolved by the placement of ear drops twice daily for the weeks following surgery. If an incision has been made behind the ear, dissolvable sutures are used and should be treated with an antiobiotic ointment such as Bacitracin OTC once or twice daily until completely healed.

A dressing is placed over the ear on the day of surgery and the patient should follow up in the office the following day for dressing removal, initiation of ear drops and further instructions. Pain medicines are utilized for 1-2 days following surgery and antibiotics given for approximately five days. The patient can usually return to work after three days depending on the type of work.

No smoking is permitted for the two months following surgery and should be withheld at least one month prior.  Flying should be avoided for at least three weeks following surgery.

Water should not enter the canal until cleared by your physician. It takes approximately two months for the eardrum to heal and may take longer depending on the circumstance surrounding surgery.

Risks of surgery include but are not limited to infection, need for further surgery (<10%), worsening hearing loss, dizziness, facial nerve paralysis , taste disturbance, stroke, and spinal fluid leak (all <0.01%).

If you have any questions, please do not hesitate to contact our office to speak with your surgeon.

Removal of the tonsils is one of the most common surgical procedures performed in the world.  It is performed under general anesthesia, which means one is fully asleep and unconscious. As in any surgical procedure involving the throat a certain amount of discomfort is to be expected following the procedure and this may last anywhere from 3-14 days depending on the patient. Age, overall health status, and smoking play a role. The younger, healthier patient generally heals more rapidly and requires less post-operative pain medications.

Hydration is the most important factor in helping one heal following tonsillectomy. Fluids are encouraged in the form of water, Gatorade, popsicles, apple juice and the like. Citric and tomato juices should be avoided as they may aggravate discomfort. Dairy products are safe to use the day after surgery. Soft foods are encouraged as soon as possible. Slurpees and milkshakes should be taken with a spoon rather than a straw.

If adenoidectomy is performed at the same setting, saline nasal drops are encouraged to help promote healing following surgery. Nose blowing should be avoided for 10 days.

The risk of bleeding following tonsillectomy ranges from 1-3% depending on which study one may read. Bleeding may occur at any time up to 14 days following tonsillectomy. Bleeding may be light and brief or may require admission and even return to the operating room. If bleeding lasts longer than 10 minutes the patient should go directly to the nearest emergency room and have them notify your surgeon. Since its inception, Southeast Michigan Ear Nose and Throat admission and bleeding rate is less than 1%.

Dehydration is extremely rare but in a child requires readmission for IV fluids. Monitoring a child’s urine output as well as their overall energy level is a good sign of their level of hydration. Encourage your child to drink fluids throughout the days following surgery.

Patients are prescribed antibiotics and pain medications following surgery. Prescribed medications should be used as directed. Overuse of pain medicines may cause constipation and may result in nausea and even fever after several days of use and should be alternated with non-narcotic pain medications such as regular Tylenol.

Tonsillectomy has excellent success rates (>99%) and when indicated relieves the patient of numerous throat infections and / or difficulties with sleep such as snoring and sleep apnea. It may be performed in conjunction with uvulopalatopharyngoplasty (UPPP) in adult patients with sleep apnea. It may also be required in the setting of certain types of cancer (tonsil cancer, neck cancer with an unknown source, and lymphoma).

If you have any questions please do not hesitate to call our office to speak to your surgeon or a member of our staff.

 

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