Avoid Empty Nose Syndrome
- Posted on: Jul 3 2019
How can I avoid getting an “empty nose”?
Many patients have had sinus issues for years and have begun to do research about how this condition can be corrected.
During their research they see a frightening condition called empty nose syndrome resulting from sinus surgery.
This syndrome is described as a dry and chronically congested nose with constant associated sinus infections.
Understandably patients can be concerned that if they proceed with a sinus procedure that they may end up with this complication and therefore they are quite hesitant to seek care.
Empty nose syndrome goes back to the 1970’s and 1980’s when ENT doctors and plastic surgeons would frequently remove the lower turbinates as part of a nasal procedure. They thought that this would improve the nasal breathing and did not understand the negative consequences of this removal. These lower turbinates serve to filter, humidify, and warm the air as it enters the nose. Once removed a dry, cold, and unfiltered air robs the nasal lining of moisture. The lining becomes chapped and vulnerable to bacterial colonization. It also disrupts the cilia from functioning and creates an environment prone to sinus infections. Ironically the patient is more congested not less as the dry environment creates crusting, infection, and inflammation.
By 1990 it was evident in the literature that the practice of removing part or all of these lower turbinates was not appropriate. Unfortunately there are still many ENT doctors and plastic surgeons that still do turbinate removal procedures. Many also remove other vital structures in the nose such as the middle turbinates and ethmoid sinus cavities which also may leave the patient with empty nose syndrome.
A reduction of the turbinate with a technique similar to liposuction is the correct procedure (submucosal turbinate reduction). In this procedure the turbinate is entirely preserved with a simple removal of the swollen inflammation under it’s lining. This preserves all of the turbinate function and makes the patient breathe better.
Balloon sinuplasty with preservation of the middle turbinates and all of the normal ethmoid sinus anatomy also allows for resolution of chronic sinus issues without the risk of empty nose syndrome.
It truly is buyer beware as unfortunately many ENT surgeons and plastic surgeons are still working with outdated concept of removing valuable intranasal and sinus anatomy placing the patient at risk for an empty nose syndrome.
If you are contemplating a nasal or sinus procedure see us for a second opinion to hear about the modern non-invasive strategies that can resolve your breathing and sinus issues and not create empty nose syndrome.
Posted in: Sinus and Nasal