Before and after surgery
General guidance for the main operations, so that you know what to expect and when to ask for help. You will receive instructions for your own operation; where they differ from this page, follow the instructions Dr Kana has given you.
! For heavy bleeding or difficulty breathing, go to the nearest emergency unit straight away; in South Africa, dial 112 from a mobile phone.
Sinus surgery
Before
- Bring your sinus CT scan, or a link to it, and a list of all your medicines.
- Follow the anaesthetist’s instructions about when to stop eating and drinking.
- Do not stop aspirin, blood thinners or other medicines unless Dr Kana or your own doctor tells you to.
- If you smoke, stop for as long as possible before surgery; smoking slows healing.
On the day
- The operation is done through the nostrils under general anaesthetic.
- Expect a blocked nose and some blood-stained discharge when you wake.
- Most patients go home the same day or the next morning, with an adult to accompany them.
Recovery at home
- Use saline rinses as you are shown, usually several times a day.
- Do not blow your nose hard for the first week, and sneeze with your mouth open.
- Sleep with your head raised on an extra pillow for the first few nights.
- Avoid strenuous exercise and heavy lifting for two to three weeks.
- Keep your follow-up visit, usually about a week after surgery, before you fly.
Call the practice or go to an emergency unit if
- bleeding from the nose is heavy or does not settle with rest and gentle pressure
- there is swelling or redness around the eye, or any change in your vision
- clear, watery fluid drips from the nose
- you have a severe headache, a stiff neck or a high fever
Ear surgery
Before
- Have a hearing test before surgery; it can often be done by the audiologists in the same rooms.
- Follow the anaesthetist’s instructions about when to stop eating and drinking.
- Do not stop aspirin or blood thinners unless a doctor tells you to.
- Tell the practice if you have a cold or an ear infection in the week before surgery.
On the day
- Surgery is through the ear canal or a small cut behind the ear, under general anaesthetic.
- You may wake with a head bandage and packing in the ear canal.
- Most patients go home the same day or the next morning.
Recovery at home
- Keep the ear dry: protect it when you shower, as you are shown, and do not swim until you are told it is safe.
- Hearing is muffled while the packing is in; this is expected.
- Sneeze with your mouth open and avoid blowing your nose hard.
- Avoid heavy lifting and straining for about two weeks.
- Ask Dr Kana before you book a flight home.
Call the practice or go to an emergency unit if
- you have severe dizziness or keep vomiting
- one side of your face becomes weak or droops
- the ear becomes more painful, swollen or red, or discharges pus
- you have a high fever
Head and neck cancer
Before
- Bring all scans, biopsy reports and letters from other doctors.
- Follow the anaesthetist’s instructions about when to stop eating and drinking.
- Do not stop aspirin or blood thinners unless a doctor tells you to.
- Ask how long you are likely to stay in hospital; it depends on the operation.
- Stopping smoking and alcohol before surgery helps healing.
On the day
- You will see the anaesthetist before the operation.
- You may wake with a drain, a small tube that removes fluid from the wound.
- After larger operations, the first night may be spent in a high-care unit.
Recovery at home
- Keep the wound clean and dry, as the nursing staff show you.
- Speech therapists in the same rooms can help with voice and swallowing as you recover.
- Results from the tissue removed usually take several days; Dr Kana will go through them with you.
- Any further treatment is planned together with the oncology team.
Call the practice or go to an emergency unit if
- the neck swells quickly or you have any difficulty breathing
- the wound bleeds, becomes red and hot, or discharges pus
- you cannot swallow fluids
- you feel tingling around the mouth or in the fingers after thyroid surgery
Snoring and sleep apnoea
Before
- Bring your sleep study report and a list of your medicines.
- Tell the anaesthetist that you have sleep apnoea, and bring your CPAP machine if you use one.
- Follow the anaesthetist’s instructions about when to stop eating and drinking.
- Do not stop aspirin or blood thinners unless a doctor tells you to.
On the day
- The operation depends on where the airway narrows: the nose, the tonsils or the palate.
- You may be monitored overnight in hospital, especially if your apnoea is severe.
- Have an adult with you when you go home.
Recovery at home
- Ask Dr Kana when to restart CPAP; after nose surgery it may need to wait a little.
- Avoid alcohol and sleeping tablets while you recover.
- Throat surgery is painful for about two weeks; take pain relief regularly and keep drinking.
- A repeat sleep study may be advised a few months later to measure the effect.
Call the practice or go to an emergency unit if
- there is bleeding from the mouth or nose
- you have any difficulty breathing
- you cannot drink enough fluids
- you have a high fever
Sialendoscopy
Before
- Bring your ultrasound or CT scan, or a link to it.
- If the gland is infected, it may need antibiotics before the procedure.
- Follow the anaesthetist’s instructions about when to stop eating and drinking.
- Do not stop aspirin or blood thinners unless a doctor tells you to.
On the day
- Sialendoscopy is usually done under general anaesthetic, and sometimes under local anaesthetic.
- The scope enters through the natural opening of the duct inside the mouth.
- Most patients go home the same day.
Recovery at home
- The gland is often swollen for a day or two; this settles.
- Drink plenty, and use sour sweets and gentle massage of the gland to keep saliva flowing.
- If a small cut was made inside the mouth, rinse your mouth after meals.
- Keep drinking plenty in the long term; it helps prevent new stones.
Call the practice or go to an emergency unit if
- the swelling keeps increasing after the first two days
- swelling spreads into the floor of the mouth or the neck, or you have difficulty swallowing or breathing
- you have a high fever or pus in the mouth
Skull base surgery
Before
- Bring all scans and letters, including those from a neurosurgeon if one is involved.
- Follow the anaesthetist’s instructions about when to stop eating and drinking.
- Do not stop aspirin or blood thinners unless a doctor tells you to.
- Plan to stay in Johannesburg for longer than after routine sinus surgery.
On the day
- Surgery is through the nostrils under general anaesthetic.
- Expect to stay in hospital for a few nights.
- You may have dissolvable packing or a soft splint in the nose.
Recovery at home
- Do not blow your nose, strain or lift heavy objects for several weeks, as Dr Kana advises.
- Sneeze with your mouth open.
- Avoid bending with your head down.
- Plan your flight home with Dr Kana.
Call the practice or go to an emergency unit if
- clear, watery fluid drips from the nose, especially when you lean forward
- you have a severe headache, a stiff neck, a fever or unusual drowsiness
- there is heavy bleeding from the nose
- you notice any change in your vision
Children’s ENT
Before
- Explain simply and honestly to your child what will happen.
- Follow the fasting times exactly; the anaesthetist will give them to you.
- Tell the practice if your child has a cold, fever or cough in the week before surgery.
- Bring a favourite toy or blanket.
On the day
- A parent can stay until your child is asleep and be there when they wake.
- Grommets take about fifteen minutes; tonsil surgery takes a little longer.
- Most children go home the same day or the next morning.
Recovery at home
- After tonsil surgery, give pain relief regularly as prescribed, not only when your child complains.
- Encourage plenty of fluids and soft food; eating helps the throat heal.
- Keep your child home for about a week after tonsil surgery, and a day or two after grommets.
- After grommets, ask Dr Kana about bathing and swimming.
Call the practice or go to an emergency unit if
- there is any bleeding from the mouth or nose after tonsil surgery, even a small amount
- your child will not drink, or is passing very little urine
- your child has a high fever or is unusually drowsy
- breathing is noisy or difficult
Make an enquiry
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