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Nasal surgery: septoplasty/rhinoplasty/septo-rhinoplasty/B.I.N.E./B.I.N.A./F.E.S.S.

At Mater Health Services we understand that being in hospital can be a very stressful
experience. This booklet aims to alleviate some of your concerns in keeping with our Mission to offer compassionate, quality care that promotes dignity while responding to patients’ needs. It explains briefly the events that may occur during your visit and the things to expect when you are discharged from the hospital.

It is, however, only a guideline as each person may require differing treatments.

If you have any questions about your treatment please ask your doctor or nurse. Our pastoral care team offers a caring support network to all patients. The dedicated members of this team will visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Some of the common nasal operations are as follows

  • Manipulation of nasal fracture is the correction of your fractured or broken nose.
  • Sub–mucous resection (SMR) is the removal of cartilage from the nasal septum to relieve your blocked nose.
  • Sub-mucous diathermy (SMD) is the reduction of bony ridges (turbinates) at the back of the nose using diathermy to relieve your blocked nose.
  • Trimming of inferior turbinates is a more traditional approach to reducing enlarged turbinates causing your blocked nose.
  • Septoplasty—rhinoplasty is the removal of cartilage from the nasal septum to relieve your blocked nose.
  • Rhinoplasty is changes made on the nasal cartilages and bones with the aim to improve the visual appearance of the nose.
  • Nasal polypectomy (B.I.N.A / B.I.N.E) is the removal of nasal polyps relieving symptoms of your blocked nose and post-nasal drip.
  • Function endoscopic sinus surgery (FESS) is carried out using an endoscope. Nasal polyps can also be removed by this method.

The type of nasal surgery you will be having has been decided by your doctor.

Expected length of hospital stay

The day following your surgery you will be transferred anytime from 7 am to the Transit Lounge then discharged at the pre-arranged time.

Our expectations

Prior to discharge

  • your pain will be well controlled
  • you will tolerate diet and fluids
  • you will be able to mobilise freely
  • you will not have any unexpected swelling or bleeding.

Pre-admission Clinic

MAH provides a pre-admission service. You will have received this service in any of the following ways:

  • from the specialty clinic to the pre-admission clinic
  • at the pre-admission clinic
  • over the phone.

The pre-admission service gathers information, initiates investigations to prepare you for your surgery, provides information regarding your specific operation and identifies discharge needs.

Things to do before you come to hospital

  • It is important for you to have completed all the tests which your doctor has ordered prior to coming to hospital. Please bring X-rays, any ECG reports and all your blood test results with you to hospital along with your medications. Your medications need to be in their labelled containers or Webster pack.
  • If you have are taking any blood thinning or arthritis medications please follow instructions provided by your pre-admission nurse or pharmacist. Sometimes it is important that these medications be stopped in preparation for your surgery.
  • It is necessary that you have nothing to eat or drink (including water, lollies and chewing gum) at least six hours before your operation. Please follow instructions provided by your doctor or pre-admission nurse.
  • It is important for you to shower and dress into clean clothes prior to coming into hospital. No skin products such as deodorant, perfume, body lotion, powders are to be used following your shower.
  • Mater Adult Hospital is unable to accept liability for losses. It is highly recommended that you leave your valuables at home for safety and security purposes. Please bring essential items only. While Mater does not take responsibility for your personal belongings our Security Office will hold any lost property that is handed in.
  • Read this booklet and have it ready to bring with you to hospital.

Before your operation

  • When you come to hospital proceed to the Day Procedure Unit, on Level 5 at Mater Adult Hospital, where you will be admitted and prepared for surgery. At different times through out your hospital stay and as a safety requirement, staff will request confirmation of your name, DOB, allergies and procedure.
  • The assessment form completed at the pre-admission service will be reviewed and your health team will plan for your individualised care while in hospital and any support you may require after discharge. Your nurse will also check that your consent form has been signed or organised to be signed before your operation.
  • Your nurse will discuss with you any concerns that you may have about your surgery and needs that you may have when you are discharged.
  • It is an infection control requirement at Mater that you will be required to have swabs • taken if you have transferred from, or worked at another health care facility, or you have had previous resistant infections. This is usually identified and attended at the pre-admission clinic. Your admission nurse will check if these three swabs have been taken and will complete the test if there are further swabs required.
  • The medications you brought to hospital will be collected. These will be returned to you when you leave the hospital. Please inform the nurse admitting you if you have been taking any blood thinning or arthritis medications prior to your admission, as these may have needed to be stopped before your operation day. It is usual for you to continue taking your other prescribed medications.
  • You may walk as much as you like. Please notify staff if you leave the ward.
  • You will have an identification armband applied. This will stay on for the duration of your stay for identification and safety reasons. If you have any known allergies, you will have a red “allergy” armband applied, for your safety.
  • Your nurse will take a set of baseline observations (temperature, pulse, blood pressure), weigh you and may ask you to provide a urine sample for routine testing.
  • Your groin and leg will need to be clipped prior to surgery to reduce infection.
  • You will be asked to dress into theatre clothing.
  • You may be prescribed a medication before you go to surgery.
  • Before you leave for theatre a pre-operative check list will be completed with you by your nurse. This check-list will be repeated in the operating reception area. Apart from your wedding band, no jewellery or metal is to be worn to theatre.
  • You will be escorted to the operating suite.
  • It is important to practise your breathing and leg exercises which you will need to commence once you have woken up from your operation.

Breathing and circulation exercises

The following exercises help prevent complications such as chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.

Breathing exercises: take five long and slow deep breaths. Each breath should be deeper than the previous breath. Think about getting the air to the very bottom of your lungs.

Circulation exercises: firmly move your ankles up and down to stretch and contract your calf muscles.

After your operation

  • You will stay in the recovery room within the theatre suite after the operation while you waken from the anaesthetic. You will be transferred on your bed to your room in the Day Procedure Unit.
  • Your nurse will take frequent observations of your vital signs (e.g. pulse) and dressings for several hours after the surgery. These will become less frequent as you recover but remain regular until you leave hospital.
  • You may have some packs in your nose (which may cause pressure) and a bolster on the outside to absorb any ooze. Your nurse will change the bolster as required. The nasal packs are usually removed the morning after your operation.
  • You will be resting in bed with your head elevated, immediately after your surgery. When you are ready to get out of bed for the first time following your surgery it is important that you have assistance.
  • About four hours after you return to the ward, your nurse will assist you to have a wash.
  • You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.
  • If you have pain or nausea, please tell your nurse as there are medications which can be given to relieve this. It is important to be comfortable.
  • The drip (IV) is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.

In preparation of going home

  • Your nurse will discuss your follow-up appointment and any discharge arrangements that have been made with you.
  • Discharge information will be given to you and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.
  • A full assessment will be made prior to transferring you to the Transit Lounge in preparation for discharge to ascertain your condition is safe for you to go home.
  • You will be transferred to the Transit Lounge anytime from 7am, the morning following your surgery. This is where you will wait for your transportation home. Those picking you up will find the Transit Lounge:
    • on the fourth floor of Mater Adult Hospital
    • just inside the ambulance entrance
    • opposite the waiting area for the Emergency Department.
  • It is still recommended to perform deep breathing, coughing and leg exercises while you are resting in bed.
  • You will recommence your normal medications.
  • Please tell the nursing staff if you have any pain so that they may give you medication to help relieve it.
  • You are encouraged to be independent with your showering and walking. Your shower should not be hot as this will overheat the body and cause faintness and bleeding.
  • You may have food and fluids as desired.
  • Your observations (temperature, pulse) will be checked before you are discharged.
  • If you had nasal packs inserted during your operation—you will be given a pain relief injection early this morning prior to removal of these packs. A clean bolster will be applied to absorb any nasal ooze. This nasal ooze can continue for seven to ten days.

Discharge advice following nasal surgery

What to expect

  • Continue to wear a nasal bolster or have a supply of tissues to use until the nasal ooze ceases.
  • Your nose will be a little uncomfortable for three to four days post-operatively. You may experience a sinus headache, or in the case of rhinoplasty—pain at the operative site. It will be blocked for a few weeks following your surgery.
  • Your pain should be controlled by simple analgesia such as Paracetamol—do not take any more than eight tablets within a 24 hour period.

What to avoid

  • Do not sniff or blow your nose for one week post-operatively or as advised by your surgeon.
  • If you sneeze, do so with your mouth open.
  • Do not take Aspirin or anything containing Aspirin. NO alcohol is to be consumed for two weeks after surgery.
  • Avoid hot baths, showers or saunas, physical exertion or any activity which will overheat the body.
  • Avoid contact sports until advised by your surgeon.
  • Avoid bumping your nose.
  • Avoid bending, lifting or straining for a minimum of 14 days and until you are advised by your surgeon.
  • Avoid smoking and smoky atmospheres and other fumes which may irritate the nose.
  • Avoid the sun if you have had a rhinoplasty.
  • You will be advised when you may return to work or school. If you need a sick certificate, please ask for one before leaving hospital. It is anticipated that you will require two weeks off work or school (this time off is not required after a fractured nose).

What to do if you experience a nose bleed

Place an ice pack on your forehead and one behind your neck and rest. If the bleeding persists beyond 10 minutes contact your doctor or return to the MAH Emergency Department.

Contacts

Please contact either your General Practitioner (GP); the Mater Adult Hospital Procedure Unit on 07 3163 8496; or the Mater Adult Hospital Emergency Department on telephone 07 3163 8111, IMMEDIATELY if you experience any of the following after discharge:

  • unexpected persistent bleeding, following treatment as above
  • you develop a temperature
  • there is dramatic increase in pain or swelling
  • any other concerns.

Mater Adult Hospital

Mater Adult Hospital is one of Brisbane’s leading health facilities for non-insured patients. It is built on a foundation of clinical excellence and a commitment to safe, compassionate care, that is:

  • quality focussed
  • technologically advanced
  • customised to patients’ needs and lifestyles.

Mater Adult Hospital provides a wide range of surgical, medical and cancer services to non-insured patients. It features a 24-hour emergency department, intensive and coronary care units, day surgery, day oncology, day respite and busy medical, cancer and surgical units.

The hospital’s Division of Medicine offers specialist services in respiratory medicine, endocrinology, gastroenterology, nephrology, cardiology, infectious diseases, dermatology, rheumatology, general surgery and medicine.

Modern facilities accommodate inpatients, outpatients, and day-only patients. General surgery is complemented by recognised surgical expertise in women’s health, orthopaedics, urology, ophthalmology, vascular surgery, oral/faciomaxillary surgery, colorectal surgery, plastic surgery, ear/nose and throat surgery and dermatology.

While in hospital, patients also have access to a range of allied health practitioners (dietitians, physiotherapists, etc.), pharmacy, hairdressing, and chaplaincy services.

For more information about Mater Adult Hospital please telephone 07 3163 8111.

Our Mission

In the spirit of the Sisters of Mercy, Mater Health Services offers compassionate service to the sick and needy, promotes an holistic approach to health care in response to changing community needs and fosters high standards in health-related education and research.

Following the example of Christ the healer, we commit ourselves to offering these services to all without discrimination.

Our Values

Mercy: the spirit of responding to one another
Dignity: the spirit of humanity, respecting the worth of each person
Care: the spirit of compassion
Commitment: the spirit of integrity
Quality: the spirit of professionalism

Acknowledgments

Staff of Mater Adult Hospital, Raymond Terrace, South Brisbane, Q 4101
Reference: Milliman CareGuidelines: Inpatient and Surgical Care/Ambulatory surgery/Home Care, 12th Edition, 2008

Mater Adult Hospital
Raymond Terrace, South Brisbane Q 4101

Telephone: 07 3163 8111

© 2009 Mater Meisericordiae Health Services Brisbane Limited. ACN 096 708 922