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Dacryocystorhinostomy

WHAT YOU NEED TO KNOW:

Dacryocystorhinostomy (DCR) is surgery to help tears drain. It is used when the nasolacrimal duct is blocked. This is the main tear duct that allows tears to drain from the eyes. A new drain system will be created by joining your lacrimal sac with your nasal cavity. Tears will drain directly into your nasal cavity.

DISCHARGE INSTRUCTIONS:

Seek care immediately if:

  • You have trouble breathing.
  • You have severe pain.
  • You have red streaks on the skin around your nose.

Call your doctor or surgeon if:

  • Your symptoms do not improve within 1 week.
  • Your nose bleeds more than you were told to expect.
  • You have a fever.
  • Your nose is red, swollen, and draining pus.
  • Your upper teeth, gum, or nose is numb.
  • Your sense of smell or taste is different than before surgery.
  • You have a change in your vision.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Eyedrops that contain antibiotics and steroids will help prevent or treat infection and inflammation. You may need to put the eyedrops in several times each day for the first few weeks after surgery.
  • Nasal sprays help keep your nose moist and decrease swelling and congestion.
  • Decongestants help reduce nasal congestion and help you breathe more easily.
  • Antibiotics given as pills will help prevent or treat a bacterial infection. This may be needed in addition to the antibiotic eyedrops.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Do not blow your nose:

The increase in pressure can cause bruising, swelling, and bleeding. Try not to sneeze. If you have to sneeze, keep your mouth open to decrease pressure in your nose. Use a nasal spray as directed to remove mucus and to keep your nose clear.

Apply ice:

Apply ice on your nose for 15 to 20 minutes every hour for the first day. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.

Elevate your head and upper back:

Keep your head and upper back elevated when you rest, such as in a recliner. Place extra pillows to support your head, neck, and shoulders when you sleep in bed. Elevation will help decrease swelling.

Self-care:

  • Rinse your nose with saline, as directed. Mix ½ teaspoon of salt and ¼ teaspoon of baking soda with 1 cup of warm distilled water. Nose rinses help remove crusts and prevent infection. Apply petroleum jelly to your nostrils after you rinse your nose. You may have gauze taped under your nostril openings. Change the gauze if it gets wet or dirty.
  • Use a cool mist humidifier. A cool mist humidifier will increase air moisture in your home. This will help keep your nose and throat moist and prevent irritation.
  • Limit activity for 3 days or as directed. Do not lift objects over 20 pounds. Ask when you can return to your usual daily activities.
  • Do not smoke for at least 2 days after your surgery. Smoke can irritate your nose and delay healing. Nicotine and other chemicals in cigarettes and cigars can also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Follow up with your doctor or surgeon as directed:

You may need to return for tests to check the surgery area. Stents may also need to be removed. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.