Nose

Sinus Surgery In Children

(A) Frontal Sinus 

(B) Ethmoidal Sinuses

(C) Superior Turbinate
(D) Middle Turbinate

(E) Inferior Turbinate

(F) Maxilary Sinus
(G) Lacrimal Sac

(H) Naso-lacrimal Duct

( I ) Nasal Passage
Figure 1. Cross section of the nasal septum. Many blood vessels converge in the inner lining at the front portion of the nose

WHAT IS FESS?

Functional endoscopic sinus surgery or FESS is done to treat severe sinus infections or complications that arise from sinusitis. The ENT surgeon uses small instruments to go through the nose and open the sinuses. This procedure helps to restore normal drainage in the sinuses, thereby minimising future sinus infections.

WHAT ARE THE DANGERS ASSOCIATED WITH THE SURGERY?

As the sinuses are located deep within the nasal cavity next to the eye and the brain, these major structures may be affected less than 1% of the time. If this indeed happens, your child may require a second or subsequent operation to repair the injured structure.

There is a very small risk of blindness or brain damage when this occurs.

Treatment

SURGERY

The operation will be done under general anaesthesia and does not leave any visible scar. Your child may be admitted one night before the operation.

After the surgery, there will be a surgical sponge inside your child’s nose for wound care. Your child will be instructed to breathe through their mouth for one to two days until the doctor removes the nasal pack.

POST-SURGERY INFORMATION

Your child should rest at home for the first 24 hours after discharge. We will advise avoidance of school and group activities for another 2 weeks. This prevents the child from catching a viral infection. Getting a viral infection will increase the risk of post-surgery nose bleeding. We also advise against heavy exercise such as biking, running, or swimming for 2 weeks.

DIET

It is important to drink a lot of clear fluids for the first 3 days after surgery. Your child may return to a normal diet the day after the surgery. Avoid hot foods as this may cause bleeding in the nose.

PAIN

Your child may have a stuffy nose or discomfort after the surgery. Usually, paracetamol is sufficient to manage the pain. Please inform your doctor if the pain persists beyond a week or is not relieved by paracetamol.

BLEEDING

Your child may experience mild bleeding or mildly blood-stained mucus from the nose (mild spotting on tissue paper) for the first 3 days after surgery. Should the bleeding be persistent, like a tap which cannot be turned off, please contact your doctor immediately.

MEDICATIONS

  • An antibiotic will be prescribed to treat any residual sinus infection or prevent bacterial infection post-surgery.
  • A saline nasal spray will be prescribed to promote healing of the internal nasal wounds.
  • Your doctor may also prescribe antihistamine medication to reduce mucus production.
  • It is important to complete the medications as instructed.

WHEN SHOULD YOU GO TO THE EMERGENCY ROOM?

Heavy or persistent nose bleeding
Heavy clear watery discharge from the nose
Pain not reduced with paracetamol
Swelling of the Eyes or Face
Change in vision
Headache
Persistent fever over 38.5 degrees
Vomiting that lasts more than 6 hours after surgery

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