Nasal polyps are soft, non-cancerous growths that develop from the lining of the nasal passages or sinuses, typically due to chronic inflammation. When these growths become large enough to obstruct breathing, cause recurrent infections, or lead to a loss of smell, surgical removal is often recommended. This procedure is generally performed using Functional Endoscopic Sinus Surgery (FESS), a minimally invasive technique that accesses the sinuses through the nostrils. Understanding the post-operative journey allows for proper preparation and a smoother recovery process.
The Immediate Recovery Phase
The first week following the removal of nasal polyps involves distinct sensations as the delicate tissues begin to heal. The most noticeable initial symptom is significant nasal congestion, which often feels like a severe head cold or flu. This blockage is a normal consequence of internal swelling and the presence of any temporary packing or splints.
Patients frequently experience minor bloody drainage during the first three to five days, which is generally mixed with mucus and old blood clots. The color of this discharge may be pink or dark, and it is considered normal as long as it remains light and gradually decreases. Any discomfort is typically described as pressure or a dull ache across the face and sinuses, rather than sharp pain. Prescribed pain medication usually manages this sensation effectively.
A feeling of fatigue is common and can persist for about a week, necessitating rest during this period. Some individuals may also note a temporary sore throat or a mild, dry cough, which is often an irritation from the breathing tube used during general anesthesia. The initial sensation of intense congestion and pressure usually begins to subside noticeably after the first week.
Essential Post-Operative Care Instructions
A cornerstone of post-operative care is the use of saline nasal irrigation, which should generally begin the day after the procedure. Rinsing the nasal passages with a buffered saline solution several times a day helps to clear blood, crusts, and mucus, preventing the formation of scar tissue.
It is important to use only distilled, sterile, or previously boiled and cooled water to avoid introducing bacteria into the healing sinuses. Patients are typically instructed to take prescribed antibiotics and sometimes oral steroids starting the morning after surgery to manage infection and reduce inflammation. Medications like aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen must be avoided for at least two weeks, as they can increase the risk of post-operative bleeding.
Physical activity must be severely restricted for the first one to two weeks. Patients should avoid heavy lifting, strenuous exercise, or any activity that involves straining or bending over. These actions can increase blood pressure in the head and trigger significant bleeding. Additionally, do not blow the nose for at least ten days; if a sneeze is unavoidable, try to do so with the mouth open to equalize pressure.
Monitoring and When to Seek Medical Attention
While mild discomfort and light bleeding are expected parts of the healing process, certain symptoms warrant immediate contact with the surgical team or emergency medical services. Signs of an active infection include a high fever, severe facial pain that worsens over time, or the presence of thick, foul-smelling nasal discharge. These symptoms indicate a complication that requires prompt treatment.
Heavy or persistent bleeding is another serious concern. Bleeding that is bright red, brisk, and does not stop after leaning forward and pinching the nose for several minutes necessitates immediate medical review. Any sudden changes in vision, such as double vision, or the development of severe, unrelenting headaches are medical emergencies. Swelling around the eyes or a stiff neck are also unusual symptoms that require urgent attention.
Preventing Recurrence and Long-Term Management
The removal of nasal polyps addresses the physical obstruction but does not cure the underlying chronic inflammation that caused them to form. Post-surgical management is focused on controlling the inflammatory drivers to minimize the risk of recurrence, which can be high. Long-term maintenance therapy often involves the use of topical intranasal steroid sprays.
These prescription sprays help to reduce inflammation in the sinus lining. In some cases, a steroid medication, such as budesonide, may be added to the saline rinse solution for enhanced topical anti-inflammatory delivery. Managing associated conditions, including allergies, asthma, and aspirin-exacerbated respiratory disease, is also important for long-term success.
Patients must attend follow-up appointments with the ear, nose, and throat specialist for endoscopic checkups. During these visits, the surgeon can examine the healing cavity, remove any crusting or scar tissue, and detect the earliest signs of polyp re-growth. This vigilance allows for the timely adjustment of medication, potentially including newer biologic injectable therapies, to maintain clear airways long after the initial recovery period.