Infected Uvula post-surgery? (Photo)

Question

So I got a septoplasmy/rhinoplasty 4 days ago and everything regarding that is fine. However, after the second day, my throat was overwhelmingly sensitive. Furthermore my uvula had swollen up, making it feel like I had a pill permanently stuck in the back of my throat. I thought that it would be over but it has looked like the picture below for the past two and a half days. What can I do? Should I be worried? Absolutely terrified because I don't want another surgery.

Eric M. Joseph, MD · Answer

A swollen and ulcerated uvula can lead to discomfort and concern following rhinoplasty surgery. The good news is that this will be completely healed in around seven to ten days, and will look completely normal. If the pain and swelling is not relieved by tylenol and lozenges, you can ask your surgeon if you might benefit from a short course of prednisolone, an oral liquid steroid that may be quite helpful for symptomatic relief.Hope this helps, and wishing you well.Dr Joseph

Andrew Miller, MD · Answer

Actually, what the photo is showing is not that uncommon. The endotrachael tube was probably resting on the uvula, which created the sore. It is pretty uncomfortable, but it will go away after 7-10 days.

Sirius K. Yoo, MD · Answer

Thank you for your question.  From your photo and history, it is almost certain that the breathing tube (endotracheal tube) used during your surgery was pressing on the tip of your uvula and this lead to a pressure sore (ulcer).  The uvula and entire back of the throat are exquisitely sensitive (this is why tonsillectomy is a miserable recovery), so the pain/discomfort is usually out of proportion to the injury.  As long as you aren't having fevers/chills/sweats, its unlikely to be an infection and you should let your surgeon know so he can follow this.  He may also choose to prescribe you some numbing medications.  I hope your recovery is swift.

John Layke, DO, FACS · Answer

It is likely that during the intubation process (placing a tube to assist your breathing during surgery) that the endotracheal tube rubbed or irritated the uvula.  Relay your concerns to your surgeon as he or she will likely provide you with a simple solution, such as a topical anesthetic solution.  Best wishes!

Vincent N. Zubowicz, MD · Answer

Intubation can sometimes irritate the uvula creating an aphthous ulcer. A topical anesthetic or ice will give temporary relief until it heals.

William Portuese, MD · Answer

It's difficult to tell the photograph, we have seen aphthous ulcers present on the uvula after anesthesia and nasal surgery. Always best to check with your operative surgeon. This should not have any effect on the rhinoplasty results

David Reinstadler, MD · Answer

It is not uncommon to have the throat be the most irritated part after a rhinoplasty. There are usually a combination of factors which contribute to this. The initial placement of the breathing tube, the slight movement of the tube during surgery, and the suctioning of the throat at the end of the procedure can all contribute to your situation. It will continue to improve over the next few days but you should let your surgeon know. Ice water helps with some of the swelling and pain but it is like a scratch or abrasion anywhere else that will just take time for the body to heal. Best of luck

Stephen Weber MD, FACS · Answer

Most likely this resulted from the breathing tube or LMA placing pressure on your uvula during surgery. Call your plastic surgeon's office and have them evaluate this ASAP. It likely will heal very nicely in time. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Inessa Fishman, MD · Answer

Though I'm not sure what kind of anesthetic you received with your septorhinoplasty, I would guess it was a general anesthetic with an endotracheal (breathing) tube.  The photo provided looks like superficial irritation from the pressure and rubbing of a breathing tube.  Though the photo does not suggest infection, the uvula is a sensitive structure, and inflammation within it will often make the uvula feel huge--like something is stuck in the back of the throat.  I would discuss your concerns with your surgeon, including whether you have any symptoms such as fevers, chills, trouble breathing, etc.  Oftentimes, warm saltwater gargles throughout the day and tincture of time can be very helpful for uvula irritation, which usually resolves in days-a few weeks.  Good luck in your recovery.

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