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Severe pain after sinus surgery. How long will it take to recover?

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ENT Specialist
Practicing since : 1991
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Hi my sister just had an operation for polyps and a large growth in her sinus cavity - it has been 8 days since surgery ans she still has severe pain? She has had so much pressure and pain in her head for a year and a half she had been carrying a cold pack on her head to family gatherings - does it normally take a while for the pain to subside after the surgery? Worried about her Thanks
Posted Sun, 7 Apr 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for your query.

1. It is unusual for severe pain to exist 8 days after a sinus surgery unless there was excessive handling or destruction of the tissues such as during severe bleeding during surgery, bony infiltration of the sinus growth or very severe infection before surgery.

2. You should check with the surgeon and the surgical notes.

3. Another possibility is that the growth in the sinus was involving a nerve that was causing severe pain pre-operatively, which has not been relieved after the surgery.

4. It is common for nasal discharge, blockage, mild discomfort to persists for 4-6 weeks after sinus surgery, but not severe pain. What us the exact location of the pain?

5. If you can share the CT Scan images of the pre-operative (and post-operative scans, if possible), I will be able to give you an accurate assessment.

6. Her pain medication must be reviewed. Any signs of infection or inflammation must be treated. Was there any other cause of headache such as migraine suspected? Is she diabetic? What was the HPE report of the removed polyps and growth?

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Severe pain after sinus surgery. How long will it take to recover? 40 hours later
thank-you for your detailed reponse - her surgery has been 18 days ago - and she has some more large mucous clots recently come out - she has pressure in her head still and still needs a cold pack on her head to make it bearable - prednisone has helped but not solved the issue - could she have some edema for some reason - she has had half her thyroid taken out and ever since then she has gained weight and puts on water easily - she is seeing her surgeorn on wed Thanks
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for writing back.

1. I normally see a patient within one week post-operatively to clean the nasal cavity, which is usually blocked with crusts, debris and thick secretions.

2. The patient usually starts saline nasal douching after three to four days.

3. She should have her nose cleaned and get a check nasal endoscopy done. It is unusual for severe pain to persist two and a half weeks after sinus surgery.

4. There is bound to be some edema, but this usually settles down in two to four weeks. Do not hesitate to get a post-op CT Scan done if her symptoms are severe, worsen or persist beyond a four to six weeks.

5. A hemithyroidectomy is not an issue unless she has hypothyroidism, which can lead to slow healing. Get her thyroid function tests done.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
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