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Nose and sinus care after a maxillectomy | CION Cancer Clinics
After a maxillectomy the space left in the upper jaw opens into your nose and sinus, and it no longer clears mucus on its own. Crusts and thick mucus are expected. Rinsing gently with salt water, in the way your team teaches you, keeps the cavity clean and easier to check. This page explains why, how it is usually done, and which signs cannot wait. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why does the nose need daily care after a maxillectomy?
- How is a salt water rinse usually done?
- What will you notice in your nose in the first months?
- What do the terms in your discharge notes mean?
- What do families believe about nose care, and what is true?
- What can this page not tell you about your own nose?
- Common questions about nose and sinus care after maxillectomy
The short answer
Why does the nose need daily care after a maxillectomy?
After a maxillectomy the space where the upper jaw bone was removed opens into your nose and sinus. That space no longer clears mucus on its own, so crusts build up, and rinsing it with salt water as your team shows you is how you keep it clean and comfortable.
What has changed inside
The lining of a healthy sinus has tiny hairs that sweep mucus towards the throat. Surgery removes part of that lining, and the new surface takes months to settle. Air now reaches places it never used to, which dries the surface. The result is thick mucus, dry crusts and sometimes a smell that you notice more than anyone around you.
Why rinsing helps
A salt water rinse softens crusts and washes them out before they harden, block the nose or become infected. It also keeps the cavity easy for your surgeon to see at follow-up visits. That matters, because looking inside the cavity is one way the team checks that the area is healing and that nothing new is growing.
Who this page is not written for
If your operation was closed with a flap rather than an obturator (a removable plate), the cavity may be sealed from the mouth and the routine can be different. Follow the instructions written for you.
Your own team's instructions come first. This page explains the reasons behind them; it does not replace them.At home
How is a salt water rinse usually done?
Get the water right
Use water that has been boiled and allowed to cool until it is only just warm, or sterile water from the pharmacy. Mix in salt, and baking soda if your team suggests it, in the amounts they give you. Never use tap water straight from the pipe.
Take out the obturator
If you wear one, remove it first and wash your hands. Lean forward over a basin with your mouth open and your head tilted down, so the water runs out of your mouth or the other nostril rather than towards your throat.
Rinse gently
Squeeze the bottle or syringe slowly into the nostril on the side of the operation. Some teams also teach rinsing through the opening in the mouth. Let the water, crusts and mucus drain out. Do not force it, and stop if it hurts.
Clean up after
Blow the nose gently, one side at a time. Wash the bottle and let it dry in the open air. Clean the obturator before putting it back, and replace the bottle as often as your team advises.
Not sure whether this applies to you?
Ask an oncologistNormal, and less normal
What will you notice in your nose in the first months?
Most of these are expected while the cavity heals. Knowing which is which saves a lot of worry.
Crusts
Dry, brown or green crusts are the most common complaint. They come away with rinsing. Pulling them out with fingers or cotton buds can cause bleeding, so let the water loosen them instead.
A blocked or stuffy feeling
Swelling and crusts can make the nose feel blocked on the side of the operation. It usually eases as healing goes on. Tell your team if it gets steadily worse rather than better.
Smell and discharge
A mild smell from the cavity is common, especially first thing in the morning. Thick yellow or green discharge with a bad smell, fever or cheek pain is different, and needs a call.
Often worse
- When rinses are skipped
- During radiotherapy
Streaks of blood
A little blood mixed with mucus after rinsing is common early on. A nosebleed that keeps flowing, or fresh blood in larger amounts, is not something to wait on.
!
When not to wait
Go to your surgical team or the nearest emergency department the same day if a nosebleed does not stop with steady pressure, if you have fever with a spreading swelling of the cheek or around the eye, if your vision changes, or if clear watery fluid keeps dripping from the nose. Do not pack the nose with cloth or cotton and wait for the morning.
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Words you will hear
What do the terms in your discharge notes mean?
- Maxillary sinus
- The air space inside the cheekbone. After a maxillectomy part or all of it has been removed and joins the nose and mouth.
- Nasal irrigation or douching
- Rinsing the nose and cavity with salt water to wash out mucus and crusts.
- Crusting
- Dried mucus that sticks to the healing surface. Expected, and the main reason rinsing is taught.
- Obturator
- A removable plate that seals the gap between the mouth and the nose so you can eat and speak more normally.
- Nasal endoscopy
- A thin camera passed into the nose at a clinic visit, so the surgeon can look at the cavity and clean it.
- Humidification
- Adding moisture to the air you breathe, for example with steam, to stop the lining drying out.
Commonly believed
What do families believe about nose care, and what is true?
"Rinsing will wash away the stitches or open the wound."
A gentle rinse, done the way your team shows you, does not open a healing wound. Leaving crusts to harden is more likely to cause bleeding and infection. If you are unsure when to start, ask before you leave hospital.
"Oil, ghee or home drops will soften the crusts better."
Putting oil or home remedies into the cavity is not advised. Oil can be breathed into the lungs and can trap germs against the healing surface. Stick to the salt water your team recommends, and ask them before trying anything else.
"A smell from the nose means the cancer has come back."
A smell is far more often old mucus or crusts sitting in the cavity. It usually improves with regular rinsing. It still deserves a mention at your next visit, because the surgeon can look inside and tell you what is causing it.
"Once the wound heals, the rinsing can stop."
Many people need to keep rinsing for a long time, and some do it for life, especially after radiotherapy. The amount often drops as the cavity settles. Your team will tell you when it is safe to rinse less often.
Being straight with you
What can this page not tell you about your own nose?
This page cannot tell you how often you should rinse, which solution suits you, or when to start. Those depend on the size of your operation, whether you have an obturator or a flap, and whether radiotherapy is planned. Your surgeon and nurse set that routine for you.
Radiotherapy changes the routine
If radiotherapy follows surgery, the lining of the nose and mouth becomes drier and more tender for a while. Crusting often gets worse during this time. Teams usually ask for more frequent rinses and add steam or other moisture. Tell the radiotherapy team about any bleeding or pain.
Medicines are for your doctors to decide
You may be given nasal sprays, antibiotics or drops. Do not start, stop or change any of these on your own, and do not use a spray bought over the counter without asking. Some of them dry the lining further.
If you are caring for a parent, learn the rinse yourself before discharge. Many people find it hard to do alone in the early weeks.Questions we are asked
Common questions about nose and sinus care after maxillectomy
When can I start rinsing my nose after the operation?
That depends on how your wound was closed and whether packing was placed. Some teams start rinses within days, others wait until the first clinic visit. Ask for the start date and the routine to be written down before you go home, so there is no guessing once you are there.
Can I use normal tap water for the rinse?
No. Tap water can carry germs that are harmless to drink but not safe inside a healing cavity. Use water that has been boiled and cooled, or sterile water. Make a fresh batch as your team advises, and keep the bottle clean and dry between uses.
Is it normal for water to come out of my mouth when I rinse?
Yes, when the cavity opens into the mouth. That is why you remove the obturator and lean over a basin. If water comes through the nose while you are drinking with the obturator in, that is a separate problem with the seal, and your prosthodontist should check the fit.
Can I blow my nose?
Gently, one side at a time, once your team says it is safe. Blowing hard in the early days can cause bleeding or push air into the tissues of the cheek. If you need to sneeze, try to do it with your mouth open to take the pressure off.
Why do I have headaches or cheek pain?
Crusts blocking drainage are a common cause, and rinsing often helps. Pain that keeps building, or pain with fever, swelling or a bad-smelling discharge, can mean infection and should be checked. Tell your team rather than taking painkillers and waiting.
Will my sense of smell come back?
It varies. Some people notice little change, and others have a weaker sense of smell, especially after a larger operation or radiotherapy. It can improve as the crusting settles. Your surgeon can tell you what is likely, based on what was removed in your case.
Can a family member do the rinse for my father?
Yes, and it often helps, particularly for older patients or anyone with weak hands. Ask the nurse to teach you both before discharge. The person helping should wash their hands, use the same clean equipment, and stop if it causes pain or bleeding.
Does steam inhalation help?
Many teams suggest it to keep the lining moist, and some people find it loosens crusts. Be careful with hot water, because burns are a real risk, especially if the face feels numb after surgery. Ask your team whether steam suits you before you begin.
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Sources
- National Cancer Institute — Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ) - Patient Version
- American Cancer Society — Surgery for Nasal Cavity and Paranasal Sinus Cancer
- Macmillan Cancer Support — Head and neck cancer
- NHS — Sinusitis (sinus infection)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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