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Rhinoplasty and septoplasty done. Started having severe headaches and nausea. What is causing this?

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ENT Specialist
Practicing since : 1991
Answered : 2543 Questions
Dear Surgeon,
Last Friday I had both rhinoplasty and septoplasty at a plastic surgery clinic. The surgery took around 5 hours which was a lot longer than I had expected. Anyway, right after the surgery I started having severe headaches, and although I vomited only once my nausea persisted for the entire day.
Feeling terrible, I went back to the doctor and he prescribed me some pain relievers but they are not alleviating my headaches completely. It's been almost a week now and my headaches haven't disappeared. Actually, I have high blood pressure and my blood pressure used to be 140/90 but after the surgery it's 150-160/100-110. Is there any possibility that my headaches are linked to high blood pressure? Or is it simply a common aftermath? How much longer will I have to wait til they go away and is there anything else more effective I can use or do? Would you recommend seeing an ENT specialist at this point? If so, do you think a nose endoscopy would be necessary? With both rhinoplasty and septoplasty done, is it safe to insert it into my nose? Thank you.
Posted Sun, 25 Nov 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 3 hours later

Thank you for your query.

1. Septorhinoplasty is often done as a combined procedure. If 5 hours was the actual procedure time, that would be unusual. Common reasons for delay are anesthesia related or excessive bleeding (high intra-operative blood pressure). These may be mentioned in your detailed operative notes.

2. If your nose had been tightly packed, headache may occur. One episode of vomiting and prolonged nausea is commonly seen after General Anesthesia lasting for many hours as in your case.

3. Usually the headaches should have decreased after nasal pack removal which is done 24-48 hours after surgery.

4. High blood pressure may cause headache that lasts two or three days longer after the blood pressure comes down to normal. Anxiety and pain will also increase blood pressure so it is difficult to postulate unless the blood pressure is brought down with medication. This blood pressure is unusual for your age.

5. I would recommend that you get examined by an ENT Specialist. A gentle nasal endoscopy is not contraindicated and may help in understanding the situation. Edema, infection, blood clots, crusting, sinus blockages, CSF leaks and any foreign body should be ruled out.

6. A CT Scan is not advised as yet as the edema from the surgery will render it useless at this stage. Scanning will have to wait for a few weeks and be done only if your symptoms do not subside.

7. You may share the images and results from your examination for further advise. Severe headaches and high blood pressure are not common post operative complaints and must be treated with anti inflammatory painkiller drugs and anti-hypertensives.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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