Procedure Instructions
POST OP INSTRUCTIONS EXCISION OF NODE/MASS OF NECK
DEFINITION – surgical removal of node or mass through an incision
FOLLOWING YOUR PROCEDURE- No aspirin products, or ibuprofen such as Motrin or Advil
- Watch for redness and/or swelling around surgery site
- Watch for increased drainage from surgery site
- Report elevated temperature
- Change bandage on surgery site as needed (if bandage needed)
- Apply antibiotic ointment twice a day (as directed by your physician)
- Keep head elevated
- You will be off work/school for approximately 2-7 days (the doctor will specify).
- A post operative appointment should be made approximately 4-7 days after surgery.
POST OP INSTRUCTIONS EXCISION OF SUBMANDIBULAR GLAND
FOLLOWING YOUR PROCEDURE- No aspirin products, or ibuprofen such as Motrin or Advil.
- Keep head elevated.
- Apply antibiotic ointment twice a day to wound site after cleaning gently.
- Clean area by dabbing with a gauze pad dampened with hydrogen peroxide.
- No heavy lifting (greater than 10 pounds), bending, or straining.
- You will be off work/school for approximately 2-10 days (the doctor will specify).
- Report any excessive drainage or bleeding, elevated temperature, redness, or swelling.
- A post operative appointment should be made approximately 1-2 days after surgery if there is a drain in the incision.
- A post operative appointment should be made approximately 5-8 days after surgery if there is NO drain in the incision.
EMERGENCY (AFTER HOURS) PHONE NUMBER: 675-0616
POST OP INSTRUCTIONS EAR SURGERY (TYMPANOPLASTY and/or MASTOIDECTOMY)
GENERAL- DO NOT BLOW YOUR NOSE for two weeks following surgery. Any accumulated nasal secretions should be sniffed back and expectorated through the mouth. If you sneeze, do so with your mouth open. DO NOT stifle a sneeze.
- Remove the ear bandage on the first post-operative day. You can expect some bloody drainage during the healing period. Use a small piece of cotton to absorb such drainage. When there is no further discharge, leave the cotton out and the ear open to air in order to encourage the healing process.
- Start the antibiotic medication the evening of your surgery and complete the prescription. Some discomfort I n the area of the operation is to be expected. Take Tylenol in your usual dosage for minor discomfort. If this medication is not adequate, then fill the prescription for pain relief medication and take as directed.
- Any pus or foul smelling discharge should be reported to the office immediately. If there is an incision behind or abo e the ear, leave the adhesive strips in place until your post-operative visit or until the strips fall off.
- You may note gurgling or popping noises in your ear during the healing period. These noises are normal and do not indicate a problem.
- You may note a full sensation in the ear. Try yawning or swallowing to relieve this sensation.
- Avoid rapid head motion and sudden positional changes.
- Call the office if you develop a cold or if discharge from the ear persists longer than one week.
- Do not be concerned regarding your hearing for 6-8 weeks following surgery. It takes several weeks before complete healing occurs.
- If dizziness is not present, automobile driving may be resumed several days after leaving the hospital. Remember that quick head motion may cause transient unsteadiness. A reasonable amount of caution should be used until you have fully recovered from all effects of the operation.
- Water should be kept out of the ear until healing is complete. You may give yourself a wet shampoo two days after surgery, provided water is not allowed to enter the canal.
- Saturate a small cotton plug, about the size of your htumnail, with Vaseline. Place the plug into the outer opening of the external ear canal. Smear Vaseline over the shell-like part of the ear, thus forming a water seal.
- You may resume your normal routine, however, avoid any strenuous activiites that cause panting and jarring for at least two weeks.
- Avoid undue exposure or fatigue.
- You may resume your usual dietary habits upon leaving the hospital.
- Alcohol may be used in moderation.
POST OP INSTRUCTIONS RELEASE OF TONGUE TIE
DEFINITION – (lysis of labial frenulum) clipping of tissue connecting the tongue to the floor of the mouth
FOLLOWING YOUR PROCEDURE- Drink plenty of fluids
- Resume regular diet as tolerated
- May rinse mouth with cool, fresh water after eating
- A low grade fever (101 degrees Fahrenheit) may normally occur after surgery
- You will be off work/school for approximately one day (the doctor will specify).
- A post operative appointment should be made approximately one week after surgery.
POST OP INSTRUCTIONS DIRECT LARYNGOSCOPY or MICROLARYNGOSCOPY
FOLLOWING YOUR PROCEDURE- You must drink plenty of water and no caffeine containing beverages for the first week.
- Use a room humidifier in your bedroom for the 2 weeks following surgery if possible.
- Use a non-aspirin reliever (ex: Tylenol) for discomfort.
So that your vocal cords can heal properly:
- Avoid throat clearing (by drinking water and swallowing), and you should not whisper, sing, or shout for 6 weeks afterward if a biopsy of your vocal cord(s) is planned.
- Avoid smoking during this same time period
- Speak only in soft conversation tone of voice after 48 hours of absolute NO use of your voice.
- If your occupation allows you to follow your doctor’s voice rest instructions, you may return to work 1-2 days after the procedure. Other activities may be resumed as tolerated.
- If you have any difficulty breathing after direct laryngoscopy.
- If the small amounts of blood in your saliva are increasing rather than decreasing and have not stopped during the first 24-48 hours after the procedure.
- If any pain is increasing rather than decreasing over 3-5 days after the procedure.
- Should be arranged for one week following the procedure.
- You may schedule this on the day of your preoperative visit, or call the office after surgery.
POST OP INSTRUCTIONS NASAL FRACTURE
Closed Reduction – manipulative reduction of the fracture without an incision
Open Reduction – reduction of a fracture after an incision into the fracture site within nose
GENERAL INSTRUCTIONS AFTER SURGERYA post-operative appointment should be made approximately one week after surgery or sooner if packing was placed. You will be off work/school for approximately 2-7 days (physician will specify). If you have any questions or problems, please contact our office at 675-0616.
POST OP INSTRUCTIONS TONSILLECTOMY and/or ADENOIDECTOMY - Pediatric
DIET- Maintain abundant fluid intake for 10 days after surgery: water, soda, juice, ice chips, popsicles, Jell-O, milkshakes, etc. Citrus fruit juices may be irritating, but are not harmful if tolerated. Ice cream and milk and red beverages are allowed.
- There are no absolute restrictions to diet, and soft foods may be started immediately, but may require up to 5-7 days before being tolerated. DRINKING LIQUIDS IS FAR MORE IMPORTANT THAN EATING SOLIDS FOR THE FIRST WEEK AFTER SURGERY.
- The patient may return to school or work 7 days after surgery.
- Strenuous activity of any kind is not allowed for 3 weeks after surgery. This includes any activity causing elevation of the pulse, such as recess, physical education class, swimming, or any similar activity.
- Do not gargle. Coughing and throat clearing are to be avoided.
- Mouth odor is common for several days, is reduced by drinking fluids, and after beginning soft foods.
- Ear pain is common 5-7 days after surgery. Pain medication can be used if needed.
- DO NOT TAKE ASPIRIN OR ANY PAIN RELIEVERS OTHER THAN TYLENOL, OR THOSE PRESCRIBED BY YOUR DOCTOR. Others may increase risk of bleeding.
- Tylenol suspension every four hours while awake in children for the first few days. If Tylenol is not effective after 24 hours, an age/weight appropriate dose of ibuprofen may be given.
- Complete the entire course of antibiotics as prescribed by your doctor.
- Constipation may be a side effect of narcotic pain medication. Milk of magnesia or a glycerin suppository may be used if constipation occurs. Reduce the amount of narcotic pain medication if necessary.
- For persistent bleeding, or vomiting of coffee ground material or dark clots of blood.
- Slight bleeding may occur 5-7 days after surgery, when the yellowish-white membranes (eschar) is releasing from the tonsillectomy site. This should stop after a few minutes but if it does not, contact us immediately.
- For high fever (over 101 degrees) which does not respond to Tylenol and fluids. A low grade fever is common during the week after surgery, and is not of concern if it responds to Tylenol and fluids.
- If a persistent cough does not resolve within 10-14 days after surgery.
- For unexpected problems, should they develop, or if you have any questions.
- Within two weeks with your surgeon. This may be arranged at the time of your “pre-operative” office visit, or call as soon as possible following surgery, to schedule.
In case of emergency, call SOUTHTOWNS ENT, LLP at 675-0616.
POST OP INSTRUCTIONS SEPTOPLASTY and/or TURBINATE SURGERY
- If you have nasal packing in the nose, it will be removed at your first postoperative visit.
- Elevate your head and shoulders on 2-3 pillows for 48 hours after surgery. A recliner may be more comfortable.
- Do not blow your nose for ten days after surgery. You may gently sniff to clear drainage.
- Expect moderate amounts of blood discharge. Change your dressing as needed if it becomes soiled. If you experience excessive bleeding with dressing every 10-15 minutes, call our office.
- The day after surgery or the day of packing removal, we will give the patient saline rinse directions. Also apply an antibiotic ointment (bacitracin, polypro, Neosporin, etc) three times daily in each nostril. Continue the above until your physician instructs differently. Both of these items are found over the counter in any drugstore.
- DO NOT TAKE ASPIRIN, IBUPROFIN, or related medications for 10 days after surgery. Take only the medications prescribed or Tylenol.
- Activity should be gradually increased, but you should not lift over 10-15 lbs, or exercise more strenuously than fast walking for two weeks following surgery. You may return to work with these guidelines in mind, as soon as you feel well enough.
If you experience any problems that cannot wait until your next visit, call 675-0616 to reach your physician.
POST OP INSTRUCTIONS UVULOPALATOPHARYNGOPLASTY (UPPP)
Your first postoperative visit should take place 1-2 weeks after discharge from the hospital.If you experience any problems that cannot wait until your next office visit, call 675-0616
GENERAL
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Your surgeon has recommended endoscopic nasal and sinus surgery. Following this procedure you may experience temporary difficulty breathing through your nose due to swelling of the mucus membranes, or nasal packing.
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Decongestants and antihistamines will not relieve this nasal congestion, but it will subside when any packing is removed, and again as periodic cleaning of the sinus cavities is performed during your post-operative visits.
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You may experience moderate headaches, numbness, or discomfort in your upper teeth or nose and you will probably have some light to moderate discharge of blood from the front of your nose for 1-2 days.
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You should change the gauze dressing under your nose when it becomes soiled. This may occur up to three times per hour initially, but it will quickly subside over 24-48 hours. You may discontinue the dressing once drainage has subsided.
DIET
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There are no dietary restrictions, but you should drink extra water and fluids for 4-5 days after surgery.
ACTIVITY
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Avoid strenuous activity (jogging, aerobic exercise, frequent bending or lifting of objects greater than 20 pounds) for 7 days after surgery, and then gradually increase activity level over the ensuing week.
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DO NOT BLOW YOUR NOSE until your physician has given permission. If you must sneeze, do so gently and through your mouth so as to not stifle the sneeze. Sniffing gently is allowed.
POST-OPERATIVE SINUS IRRIGATIONS
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Please read carefully the separate instructions for NASAL IRRIGATION. These instructions and irrigation bulb will be provided at your pre-operative visit. Begin irrigation the day after surgery, unless instructed otherwise by your doctor.
POST OP INSTRUCTIONS ENDOSCOPIC SINUS SURGERY
GENERAL- Your surgeon has recommended endoscopic nasal and sinus surgery. Following this procedure you may experience temporary difficulty breathing through your nose due to swelling of the mucus membranes, or nasal packing.
- Decongestants and antihistamines will not relieve this nasal congestion, but it will subside when any packing is removed, and again as periodic cleaning of the sinus cavities is performed during your post-operative visits.
- You may experience moderate headaches, numbness, or discomfort in your upper teeth or nose and you will probably have some light to moderate discharge of blood from the front of your nose for 1-2 days.
- You should change the gauze dressing under your nose when it becomes soiled. This may occur up to three times per hour initially, but it will quickly subside over 24-48 hours. You may discontinue the dressing once drainage has subsided.
- There are no dietary restrictions, but you should drink extra water and fluids for 4-5 days after surgery.
- Avoid strenuous activity (jogging, aerobic exercise, frequent bending or lifting of objects greater than 20 pounds) for 7 days after surgery, then gradually increase activity level over the ensuing week.
- DO NOT BLOW YOUR NOSE until your physician has given permission. If you must sneeze, do so gently and through your mouth so as to not stifle the sneeze. Sniffing gently is allowed.
- Please read carefully the separate instructions for NASAL IRRIGATION. These instructions and irrigation bulb will be provided at your pre-operative visit. Begin irrigation the day after surgery, unless instructed otherwise by your doctor.
- An antibiotic, pain medication, and sometimes Prednisone are prescribed after surgery. The antibiotic and Prednisone must be taken until gone. Pain medicine may be taken as needed.
- DO NOT TAKE ASPIRIN or products containing aspirin (including ibuprofen, Motrin, Aleve, Nuprin, etc) for 10 days before or after your surgery, unless authorized by your physician.
- For any changes in vision such as decreasing sight or double vision, bruising around the eyes, severe pain or swelling of your eye or eyelids.
- Profuse nasal bleeding (more than ¼ cup in 30 minutes)
- For any unexplained fever within 10-14 days after surgery
- For any concerns or questions, which cannot wait until your next scheduled office visit.
- First visit after surgery is generally at one week. Subsequent planned visits will be every 7-10 days for 3-4 weeks. If your first post-operative visit has not been scheduled prior to surgery, please call the office to arrange this as soon as possible.
POST OP INSTRUCTIONS: TONSILLECTOMY and/or ADENOIDECTOMY
DIET- Maintain abundant fluid intake for 10 days after surgery: water, soda, juice, ice chips, popsicles, Jell-O, milkshakes, etc. Citrus fruit juices may be irritating, but are not harmful if tolerated. Ice cream and milk and red beverages are allowed.
- There are no absolute restrictions to diet, and soft foods may be started immediately, but may require up to 5-7 days before being tolerated. DRINKING LIQUIDS IS FAR MORE IMPORTANT THAN EATING SOLIDS FOR THE FIRST WEEK AFTER SURGERY.
- The patient may return to school or work 7 days after surgery.
- Strenuous activity of any kind is not allowed for 3 weeks after surgery. This includes any activity causing elevation of the pulse, such as recess, physical education class, swimming, or any similar activity.
- Do not gargle. Coughing and throat clearing are to be avoided.
- Mouth odor is common for several days, is reduced by drinking fluids, and after beginning soft foods.
- Ear pain is common 5-7 days after surgery. Pain medication can be used if needed.
- DO NOT TAKE ASPIRIN OR ANY PAIN RELIEVERS OTHER THAN TYLENOL, OR THAT PRESCRIBED BY YOUR DOCTOR. Others increase risk of bleeding.
- Tylenol suspension every four hours while awake in children for the first 24 HRS. If Tylenol is not effective, an appropriate dose of Ibuprofen, based on weight and age, may be given.
- Complete the entire course of antibiotics as prescribed by your doctor.
- Constipation may be a side effect of narcotic pain medication. Milk of magnesia or a glycerin suppository may be used if constipation occurs. Reduce the amount of narcotic pain medication if necessary.
- For persistent bleeding, or vomiting of coffee ground material or dark clots of blood.
- Slight bleeding may occur 5-7 days after surgery, when the yellowish-white membranes (eschar) is releasing from the tonsillectomy site. This should stop after a few minutes but if it does not, contact us immediately.
- For high fever (over 101 degrees) which does not respond to Tylenol and fluids. A low grade fever is common during the week after surgery, and is not of concern if it responds to Tylenol and fluids.
- If a persistent cough does not resolve within 10-14 days after surgery.
- For unexpected problems, should they develop, or if you have any questions.
- Within two weeks with your surgeon. This may be arranged at the time of your “pre-operative” office visit, or call as soon as possible following surgery, to schedule.
In case of emergency, call SOUTHTOWNS ENT, LLP at 675-0616.
POST OP BALLOON SINUPLASTY INSTRUCTIONS
- DO NOT blow your nose for 24 hours. You may resume gentle nose blowing after that, unless otherwise directed.
- Sniff inwards gently if needed.
- Sneeze with your mouth open.
- If you have any bleeding after the procedure, use Afrin Nasal Spray (over the counter) - 2 sprays each nostril every hour as needed for 3 days only.
- Use Saline spray 5-10 times daily starting the day after procedure.
- Use Saline Irrigations 2-3 times daily starting the day after procedure.
- Sleep with your head elevated on 2-3 pillows for a couple of days, as this will help keep swelling and congestion down.
- If you use CPAP, you cannot use it for 5 days after the procedure, unless otherwise directed.
- It is normal to experience periodic congestion, headaches, and bloody drainage after the procedure for several days (1-3 weeks).
- You may either take the remaining narcotic medication prescribed to you or Tylenol to help relieve any discomfort. Do not use the other nonprescription pain medicines for one week. You may resume all of your regular medications except for prescription blood thinners and aspirin, which we will discuss with you on an individual basis.
- If you take Vitamin E or fish oil supplements, resume those 48 hours after the procedure.
- You may resume normal activities, including nonstrenuous exercise, the day after the procedure. Full activity may resume after three days
- You may go to work the day after the procedure, unless otherwise instructed.
- Avoid traveling for one week.
If you have any questions or experience any problems that cannot wait until your next office visit, please call 675-0616.
POST OP EXCISION OF MARSUPIALIZATION OF RANULA
DEFINITION – opening up a cystic like mass under tongue FOLLOWING YOUR PROCEDURE- No aspirin products, or ibuprofen such as Motrin or Advil
- Report any excessive drainage from area
- May rinse mouth with 1/2 part water and 1/2 part hydrogen peroxide
- Resume diet as tolerated
- You will be off work/school for approximately 1-3 days (the doctor will specify).
- A post operative appointment should be made approximately one week after surgery.
POST OP TYMPANOSTOMY/MYRINGOTOMY WITH EAR TUBE PLACEMENT
An opening will be made in the eardrums(s) so that a ventilating tube(s) can be inserted, and any fluid can be evacuated.
GENERAL- Avoid soapy water in the ears after tube insertion. Earplugs may be useful to keep water out when bathing.
- Custom fitted earplugs are available in a variety of colors by scheduling a fitting with our audiologist at any time.
- A small amount of blood may be expected from the ear and will cease 24 hours after ear tube insertion.
- There are no post-operative restrictions following ear tube insertion.
- You will be off work/school for the day of surgery only, and may return to usual activities later the same day, or the day following surgery.
- Generally, pain is minimal to absent following insertion of middle ear ventilating tubes. If your child is fussy or tugs at ears afterward, Tylenol (acetaminophen) or children’s Motrin (ibuprofen) may be given, unless adenoid or tonsil removal has been performed simultaneously, in which case Motrin is not to be taken 10 days before or after surgery.
- A mild antibiotic ear drop will be prescribed to be used three times daily for three days following surgery. These drops may also be used as prevention against infection if water should enter the ear at any time after surgery.
- In the unusual event of pain with drop application, please stop the drops and call our office during regular hours.
- If drainage from either ear occurs and does not clear after 2 to 3 days of using the antibiotic ear drops, or if ear drops have not been prescribed.
- If any blood is seen from the ear beyond the first 3 days following surgery.
- If significant ear pain develops at any point after ear tube insertion.
- Your first post-surgery visit will be scheduled approximately 2 weeks and then every 6 months thereafter.
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