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Nose blowing after endoscopic sinus surgery does not adversely affect outcomes.

Noel Ayoub1, Wirach Chitsuthipakorn1, Jayakar V Nayak1

  • 1Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.

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Patients can blow their nose after endoscopic sinus surgery (ESS) without worsening outcomes. This study found no adverse effects on bleeding or symptoms, suggesting judicious nose blowing may be safe post-ESS.

Keywords:
ESSEndoscopic sinus surgerySNOT-22chronic rhinosinusitisepistaxisnose blowingpostoperative carequality of life

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Area of Science:

  • Otolaryngology
  • Surgical Outcomes
  • Rhinology

Background:

  • Post-endoscopic sinus surgery (ESS) patients are often advised to avoid nose blowing.
  • Evidence supporting this common recommendation is lacking.
  • This study investigates the impact of early nose blowing on postoperative outcomes.

Purpose of the Study:

  • To assess the effect of nose blowing in the first postoperative week on subjective and objective outcomes after ESS.
  • To determine if refraining from nose blowing improves clinical results following ESS.

Main Methods:

  • A randomized controlled trial involving 40 patients undergoing ESS.
  • Patients were assigned to either blow their nose (intervention) or refrain from blowing (control) for 7 days post-surgery.
  • Outcomes measured included epistaxis (frequency, severity), Nasal Obstruction Symptom Evaluation (NOSE), Sino-Nasal Outcome Test-22 (SNOT-22), and endoscopic Lund-Kennedy scores.

Main Results:

  • No significant differences were observed between groups in bleeding events, epistaxis severity (VAS), SNOT-22, or NOSE scores at 1 and 4 weeks.
  • Lund-Kennedy scores were similar between groups at both postoperative timepoints.
  • The nose-blowing group showed improved nasal discharge subscores at 1 and 2 weeks post-surgery.

Conclusions:

  • Nose blowing after uncomplicated ESS does not appear to negatively impact key clinical outcomes or increase epistaxis.
  • Early, judicious nose blowing may be permissible following ESS.
  • Current recommendations to avoid nose blowing may not be evidence-based.