Post-Surgery Coughing: Recovery After ENT Procedures

Postoperative cough

Since I have had severe nasal allergies since childhood, I went to an otolaryngologist for an examination.
After the evaluation, the doctor diagnosed me with sleep apnea.
On May 27, I underwent surgery for a deviated septum, uvulopalatopharyngoplasty, and nasal polyp removal.
It has been almost two months since the surgery.
Before the surgery, I had persistent coughing, and during my follow-up appointment, the doctor said I had recovered, advising that I should return immediately if I experienced yellow-green nasal discharge.
However, for the past week or two, I have inexplicably started coughing again and have also been prone to choking after the surgery.
Could you please advise if this surgery can be considered successful, or should I schedule a follow-up appointment for further evaluation? Thank you.

Miss Hsieh, 20~29 year old female. Ask Date: 2020/07/20

Dr. Ji Zhaoyun reply Otolaryngology

Hello, for any postoperative issues, please consult your surgeon.
Wishing you a speedy recovery.

Reply Date: 2020/07/20

More Info

Post-surgery coughing can be a common concern, especially after ENT procedures like the one you underwent. Your history of severe nasal allergies and the diagnosis of obstructive sleep apnea (OSA) likely contributed to the complexity of your condition. The surgeries you had—septoplasty, uvulopalatopharyngoplasty (UPPP), and polypectomy—were aimed at improving airflow and reducing the symptoms associated with OSA and nasal obstruction.

It is not uncommon for patients to experience coughing after such surgeries. This can be attributed to several factors:
1. Healing Process: After surgery, the tissues in your nasal and throat areas are healing. This healing process can lead to increased sensitivity and irritation, which may trigger coughing. The presence of mucus, especially if it is thick or discolored, can also contribute to this sensation.

2. Post-nasal Drip: Following surgery, you may experience post-nasal drip, where mucus accumulates in the back of your throat. This can lead to coughing as your body attempts to clear the mucus.

3. Airway Sensitivity: The surgical procedures may have altered the sensitivity of your airway. If your airway is more sensitive than before, it may react more readily to irritants, leading to coughing.

4. Residual Allergies: Given your history of severe nasal allergies, it is possible that allergens in your environment are still affecting you. Even after surgery, if you are exposed to allergens, your body may react with coughing.

5. Aspiration: If you are experiencing difficulty swallowing or are easily choking, this could indicate that your swallowing reflex has been affected post-surgery. This can lead to aspiration, where food or liquid enters the airway, triggering a cough reflex.

Regarding your concern about whether the surgery was successful, it is essential to consider the overall improvement in your symptoms. If your doctor indicated that you have recovered and only advised follow-up for specific symptoms (like yellow-green nasal discharge), it suggests that the primary goals of the surgery may have been met. However, the resurgence of coughing and choking sensations warrants further evaluation.

It is advisable to follow up with your ENT specialist, especially since you are experiencing new or worsening symptoms. They may want to assess the healing of your surgical sites, check for any complications such as infection, and evaluate whether additional treatment is necessary.
In summary, while some coughing post-surgery can be expected, the persistence or worsening of symptoms should not be ignored. Regular follow-ups with your healthcare provider are crucial to ensure that your recovery is on track and to address any ongoing issues. If you notice any significant changes, such as increased pain, fever, or changes in your breathing, seek medical attention promptly. Your health and comfort are paramount, and your healthcare team is there to support you through your recovery process.

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