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Pre-Operative Instructions

You will normally be sent a letter from our office detailing your admission date, time and location. It is important that you obtain the necessary authorisation from your insurance company prior to any admission. For patients having a general anaesthetic or IV sedation please please note that you will be required to be nil by mouth (neither food nor water) for at least 6 hours prior to the operative procedure. For young children, it is acceptable to give them a sugary drink up to 4 hours prior to any procedure. If you are to have a procedure under local anaesthetic, although this is not mandatory, it is recommended that only light meals are taken before the operative procedure. Please bring with you any x-rays, scans, or results that you may have in your possession. Please inform Professor Dhillon, in advance, if you are taking Aspirin on a regular basis. Aspirin makes the blood thinner and reduces clotting. This can sometimes be problematic during delicate procedures such as endoscopic sinus surgery. On the day of your admission please bring all medications with you and discuss this with your anaesthetist.


Grommet Insertion

Usually only a mild painkiller, such as Paracetamol or perhaps Nurofen, is all that is required. Normally post-operative ear drops are prescribed for two days following insertion of grommets. This is to minimise the risk of infection. Sometimes a discharge may be seen from the ear following grommet insertion; this is not unusual and should not cause alarm. Avoid water getting into the ears, certainly for the first three weeks following surgery. Thereafter, use of a piece of cotton wool mixed with Vaseline in the outer ear canal, covered by a headband, such as a “Band-It”. It is acceptable to resume normal activities the day after surgery. Patients are usually reviewed three weeks after insertion of grommets and if all is well the next appointment will be between six and nine months thereafter. Grommets normally stay in for an average of 6-9 months. However, it is not unusual for grommets to extrude prematurely, sometimes quite rapidly. This is often associated with a discharging ear. In very rare instances a grommet may not extrude itself and if it is causing problems may need to be removed under a short general anaesthetic. In certain circumstances, and only in adults, can grommets be inserted under application of a local anaesthetic.


Tonsils and Adenoid Surgery

It is very common to get throat and ear pain following tonsils and adenoid surgery. The ear pain is not due to ear infection but due to referred ear pain as the nerves to the throat also serve the ears. After tonsillectomy the back of the throat has a whitish sloughy appearance, which can thereafter become quite mucky in appearance. The most important thing following tonsil and adenoid surgery is adequate oral intake, both of fluids and of solids. The process of eating and drinking allows saliva production, which has an antibacterial effect and will facilitate removal of the debris which builds up at the back of the throat. Failure to eat adequately after such surgery runs the risk of infection with secondary haemorrhage. Bleeding after tonsils and adenoid surgery is rare and occurs within the first eight hours of surgery, in less than 1% of cases. As explained above, failure to eat adequately following surgery can result in infection and the possibility of secondary haemorrhage which occurs 5-7 days following operation. In the event of bleeding following tonsillectomy contact should be made with the hospital where the operation was carried out for advice. During office hours please contact our practice staff who will contact Professor Dhillon. Antibiotics are usually given post-operatively following adenotonsillectomy to avoid the risk of infection. Following tonsil and adenoid surgery voice changes can occur, but these usually recover a few weeks after surgery. Avoid strenuous exercise for 2 to 3 weeks after tonsil and adenoid surgery.


Endoscopic Sinus Surgery

You will be prescribed strong (Voltarol or Diclofenac) or moderate painkillers (Codydramol or Tylex). You should use regular painkillers for the first few days following surgery and after 2 to 3 days your analgesic requirements should begin to subside. Antibiotics are also given post-operatively for one week following surgery to avoid the risk of post-operative infection. Following sinus surgery, post-operative bleeding of a minimal nature is quite normal. If there is constant fresh bleeding after you have returned home, please contact the ward of the hospital where you had the surgery. During office hours please contact the practice staff who will contact Professor Dhillon. Following irrigation of the nose, if advised to do so, apply either Betnesol nasal drops or Flixonase nasal spray. Restrict any strenuous activity for at least 2 to 3 weeks after sinus surgery. You will be reviewed in the outpatient department a week following surgery to remove debris from the sinus cavities.


Septorhinoplasty

Following septorhinoplasty surgery you will be sent home with a cast over the nose, which is to stay undisturbed for one week. You will be given painkillers, both strong and moderate. You will be reviewed in the outpatient department one week after surgery for removal of the cast. After removal of the cast, the skin under the cast will have developed blocked pores. You should use an exfoliating facial scrub to remove the debris from the pores. Some Sutures used during your surgery will not be of a dissolving type and will need to be removed. This will be done between 7 – 14 days following operation.