Head and Neck Surgery Follow-Up Care

There are a number of conditions affecting the ear, nose and throat that may require surgery. Taking proper precautions and carefully following your physicians’ discharge instructions is essential to the healing process after any procedure. Here are follow-up care suggestions for some common procedures performed by the otorhinolaryngology department.

Following Laryngectomy

A laryngectomy is a surgical procedure to remove the larynx, or voice box, which will result in a stoma.

• After surgery, check your incision site daily for the first week. Change the dressing according to your physician’s directions. Bathe in shallow water or use a waterproof bib when you shower, and do not swim—if water enters your stoma, it will make you cough. Keep your stoma clean and suctioned, and wear a cover to keep moisture from being lost when you breathe. Use a cool-mist humidifier by your bed.
• Plan frequent rest periods to avoid shortness of breath. Perform deep breathing and controlled coughing exercises. Ask your healthcare provider for instructions.
• Do not drive until you are off your pain medication and free of pain. This may take two to four weeks.
• Keep a pad of paper and a pen close at hand to communicate with others. Wear a medical alert pendant or bracelet to alert others to your condition. It should say “Neck Breather—Resuscitate Through Stoma.”
• Do not smoke. Do not allow others to smoke around you or in your home.
• Plan a diet that helps you avoid choking. You may receive tube feedings and progress to soft foods and liquids as your swallowing reflex returns.
• Visit a speech pathologist to develop a plan for learning to speak again. Ask your doctor about the options available to you. If needed ask about reconstructive surgery.

Following Sinus Surgery

Endoscopic sinus surgery is performed to help clear blockages in the sinuses. After the procedure, you may feel groggy from anesthesia and will likely have some discomfort. There will be a dressing under your nose to absorb drainage, and you may also have packing inside your nose. You can usually go home the same day as the procedure, as soon as you are no longer feeling groggy.

Your doctor will schedule an office visit a few days after surgery to check on your progress and to remove dried blood and mucus from your nose. Any nasal packing will be removed as well. It is normal to feel stuffiness and have pinkish or dark red drainage. Change your nasal dressing as needed, and take any prescribed medications. Also be sure to drink plenty of water. Some guidelines after surgery may include:

• Rinse your nose and sinuses with saltwater
• Sneeze with your mouth open, and avoid blowing your nose
• Avoid strenuous exercise, straining, or lifting
• Use a humidifier to keep nasal passages moist
• Do not take aspirin or ibuprofen
• Sleep with your upper body elevated
• Avoid hot and spicy foods
• Talk to your doctor before swimming or travelling on an airplane

Following Ear Surgery

There are several surgical procedures that can be performed to correct problems with the ear. Tympanoplasty is performed to repair a damaged ear drum. Mastoidectomy is the removal of the mastoid bone, which is performed if the bone is infected or to remove growths from the middle ear. Here are some basic suggestions for what to do after an ear procedure:

• Expect a small amount of drainage from the ear.
• Keep your head slightly elevated for the first 24 hours after the procedure.
• Avoid doing anything that makes your ears pop, such as blowing your nose.
• Sneeze with your mouth open.
• Shower as necessary, starting three days after your surgery. You may allow water to run across any external wounds, but do not scrub them.
• Keep the ear dry. You can place a cotton ball dabbed with a small amount of petroleum jelly in the outer ear to keep water out during a bath or shower.
• Take your medication exactly as directed by your physician.
• Avoid activities that involve heavy lifting and straining.
• Get your doctor's permission before flying in a plane or swimming.
• Ask your doctor when you may return to work. There may be special considerations depending on the type of work that you do.