As mentioned earlier after surgery for chronic sinusitis and nasal polyps, the ideal state of healing is epithelialization of the wound, but some patients do not achieve epithelialization but develop pathological changes, which can lead to adhesions at the surgical site, formation of patches at the wound, and narrowing or complete closure of the sinus opening. Usually during the recovery period of 3-6 months after surgery, the wound either epithelializes or becomes pathologic, so this is the stage where aggressive prevention of adhesions and recurrence is the key to the success or failure of the entire treatment! It can be said that the surgery is only the first step out, and there are still two big steps from success: first, regular postoperative review; second, postoperative adherence to medication.
Regular review and cleaning of the nasal cavity can effectively reduce recurrence. Many patients give up the review halfway because it is painful to clean the nasal cavity with the nasal endoscope, which is not desirable! Studies have shown that the lack of timely review after nasal endoscopy is one of the main reasons for recurrence. Regular review allows the doctor to detect new growths, scabs and adhesions, and if left untreated, blocking the sinus opening, sinusitis may quickly recur. Understanding the importance of review, let’s understand the specific content of the review.
1.Post-operative review time: once a week in the first month after discharge, once every 2 weeks in the second month, and once a month thereafter until the wound heals; 2.The main content of the review – nasal cavity cleaning. Nasal endoscopic cleaning is performed under nasal surface anesthesia to remove accumulated blood, secretions, and crusts from the wound, and to remove newborn vesicles (mucosal tissue with excessive postoperative edema), granulation, and small polyps; minor adhesions can also be separated at this time to re-expand the sinus opening. Overall, regular review allows the surgeon to clearly determine whether the wound is in a normal state of healing and to treat it in a timely manner.
Insist on medication to control the growth of vesicles and small polyps 1. The use of nasal spray hormone after surgery can be anti-allergic, anti-inflammatory and anti-edema in order to effectively control the growth of vesicles and small polyps. It is usually used for more than 3~6 months after surgery. Certain patients with allergic rhinitis often require lifelong use.
2. Mucus promoter: It helps to reduce the viscosity of sinus secretions and is helpful for the recovery of sinus. Use for no less than 3 months after surgery.
3.Oral hormone: according to the recovery of the surgical site, follow the advice of the professional physician.
It is also necessary to clean the nasal cavity daily at home to promote the recovery of mucosal function Generally, nasal cleaning is started 6~7 days after surgery, 2~3 times a day, rinsing for one to three months. Many patients may ask, “Why do I need to rinse my nasal cavity when my doctor has already cleaned it during the review? That is because although the doctor cleared the obstruction such as vesicles, small polyps and granules, nasal secretions are produced all the time, and rinsing out the pus and blood secretions from the nasal cavity can promote the recovery of the nasal mucosa function.