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How are scabs treated post deviated septum surgery ?

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ENT Specialist
Practicing since : 1991
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my husband had a deviated septum surgery . he had draining down his throat. He coughed up something he said looked like a scab. He said his throat hurts and feels like there is something in there. It seems like when he raises his voice he chokes and cant talk. Went to his follow up appt. dr put a scope down his throat she said it looked very red with maybe a growth with white crystals on it she thought maybe the anestegeoloist might have poked his throat with the tube they insert in the throat. She made him an appt with a throat specialist, but it is not until 4 wks Do you have any suggestions on what this might be
Posted Thu, 3 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 7 hours later

Thank you for your query.

1. How long is it since his surgery? Swelling, scabs and nasal blockage usually persists for up to four to six weeks after surgery. Total healing of the XXXXXXX surgical wounds can take up to six months depending upon the extent of surgery.

2. Mucociliary function can take up to twelve weeks to return to normal after nasal surgery. This causes stagnation of normal nasal and sinus secretions, leading to repeated infections. Did he have a CT Scan before surgery? There is a possibility that the sinuses are the source of his post nasal drip.

3. As long as he does do not have fever, or increasing choking episodes, there is no cause to worry. However his nose and sinuses will require regular endoscopic inspection and cleaning.

4. Usually the crusts formed in the nose after surgery are extensive and have to be removed by the surgeon as they may not be expelled by saline nasal sprays and nasal irrigation.

5. Since he has a significant post nasal drip, I would encourage him to use a nasal wash. Do not use tap water with table salt. Common household salt contains iodine and anti-caking agents which irritate the post-operative mucosa. Use Normal Saline solution.

6. Insist on a sinus swab for culture and sensitivity. Biofilm formation in the sinuses is another cause for resistant infection, not responding to medication.

7. The possibility of fungal infections exists, especially since there were white crystals or discharge in the throat.

8. If the throat is congested immediately post op, and there was an injury due to the anesthetic endotracheal tube, there is no cause for worry and it should heal soon.

9. Acid reflux may also be involved, however if there is a 'growth' I would investigate whether it is a separate entity or a result of the throat injury. Here any images or video would help in diagnosing the problem.

10. If his voice chokes and he can't talk, the possibility of a post intubation vocal fold granuloma must be ruled out. This may require steroids to control.

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

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