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Old 02-27-2008, 10:06 PM   #1
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Empty Nose Syndrome?

ve been having sinus problems for months now i finally got results of my cat scan and i dont know exactly what was said by heart..but i have a deviated septum,enlarged turbinates,puse is my left maxillary sinus,and i think she said an air pocket also..so im suppose to get surgery done in april..the 3 circled on a standard print out are septoplasty,endoscopic sinus,and turbinectomy..i have no problem with any of these except what i read about the turbinectomy when it comes to empty nose syndrome..first off in a turbinectomy is always the whole thing removed or can a turbinectomy also mean some removed so i would have to find out from my dr exactly how much is getting removed?..whats the chances of getting this empty nose syndrome problem..i think im going to go back to the ent and talk to them about it but i wanna get other opinions also here

 
Old 02-28-2008, 04:00 AM   #2
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Re: Empty Nose Syndrome?

The specifics of what the doctor is planning to do are very important, do don't be afraid to ask questions - Dr. Steven Houser, who is one of the ENTs on the front lines of diagnosing and treating Empty Nose Syndrome (ENS), believes that turbinectomies are the primary culprit behind ENS (not everyone who has their turbinates removed ends up with ENS but it's an avoidable complication).

I've read lots of Dr. Houser's information and his position (which I will quote exactly here) is "If they said turbinectomy (not turbinate reduction) then I would avoid the surgery". There are ways to reduce the turbinates safely, Dr. Houser mentions several procedures: Outfracture, Cautery, Submucosal Resection, but notes that even these can cause problems if they're done too aggressively.

Equally important to the turbinate reduction vs. turbinectomy question are two other things you should consider:

1. Has the doctor done everything medically possible to relieve your symptoms? Before you go the route of surgery I would strongly recommend that you get tested and treated for allergies (if you haven't already), try using saline rinses using a SinusRinse bottle for several weeks, talk to your doctor about whether medications like a steroid nasal spray or even a course of oral steroids might help your sinuses get back to functioning naturally. If you're already doing all of those things with no improvement and surgery is the only option then move on to #2.

2. What is the doctor's approach to surgery and post-surgical follow up? Some docs are more aggressive than others but that's not necessarily a good thing because sinus surgery can't be reversed. I believe that the best sinus surgeons are "minimalists" (to quote my surgeon) who focus on trying to restore your sinuses to their natural function. Be sure the doctor plans to see you several times after the surgery to remove any blood clots that may cause scar tissue to form. The recommended post-surgical regimen should be something like this:
-Patients are instructed not to *blow their nose for 48 hours (or more) after surgery
-An antibiotic is typically prescribed for at least 1 week
-Sometime between the 1st and 4th days after surgery the doctor should carefully remove clots and crusts from the nasal cavity
-Healing requires at least 2-4 weeks - during that time patients should return weekly so that the ENT can remove any clots or debris from the nasal cavity using an endoscope
The follow up is very important - if this isn't what your doctor recommends then consider finding a new doctor.

I always recommend that anyone considering this surgery find a doctor - at a major medical center or teaching hospital - who specializes in treating and operating on patients with chronic sinus problems for this type of surgery (vs. an office-based ENT who may treat a wide range of conditions).

 
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Old 02-28-2008, 10:27 AM   #3
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Re: Empty Nose Syndrome?

I had a bilateral turbinectomy but only part of my bone and turbinates are removed, leaving the other half to help warm the air I breathe.

Go through the surgical details clearly with your surgeon.

Surgery should be the last resort after your conservative methods like medications, sprays have been exhausted.

 
Old 02-28-2008, 11:48 AM   #4
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Re: Empty Nose Syndrome?

well we have pretty much tried alot of things i take a claritin everyday to begin with then i was put veramyst and singulair and xyzal was added to that i was on about 4 different antibiotics...the post op papers i have pretty much list everything you listed for good post op prcedure

 
Old 02-28-2008, 12:39 PM   #5
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Re: Empty Nose Syndrome?

I'd still recommend trying the saline irrigation with a SinusRinse bottle (you can get one at any major drug store). I would also discuss the turbinectomy vs. turbinate reduction with your ENT before you commit to the surgery - it's better to remove less turbinate initially so that you don't risk ENS later.

 
Old 02-28-2008, 01:28 PM   #6
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Re: Empty Nose Syndrome?

ive done the irrigation no helps actually it caused fluid build up in my ears...im definatly going to talk about reduction vs removal just to see for sure which one im having it seems liek from everything i read online drs these days dont like to do complete removal so i will bring up all the facts to him

 
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