The Empty Nose Syndrome is a postoperative condition in which the turbinates have been reduced in size too much or removed completely. This means that the function of the turbinate, which consists of humidifying the inhaled air, can no longer be adequately perceived. Despite the enlarged nasal cavity, nasal breathing is impeded.
What is Empty Nose Syndrome?
According to WHOLEVEHICLES.COM, the Empty Nose Syndrome is the so-called empty nose syndrome. It is a pathological condition that arises after the turbinates are reduced in size or even removed. Despite enlarged nasal cavities, the feeling of a blocked nose arises. The reason for this is the lost ability of the nose to humidify the inhaled air.
The air stays dry. Scabs form in the nose, which can also be the starting point for infections. There are three turbinates in humans, which can be divided into upper, middle and lower turbinates. The nasal passages, which are responsible for various functions, are located between the individual turbinates.
The upper nasal passage is located between the upper and middle turbinates. It contains the olfactory organ and is therefore also known as the olfactory duct. The nasal passage located between the middle and inferior turbinates is known as the sinus duct and ends in the paranasal sinuses.
The lower nasal passage, which can be found between the lower turbinate and the palate, serves as the actual airway. It is responsible for nasal breathing and is used to humidify the air we breathe. The turbinates also contain pressure sensors that signal the state of nasal breathing to the brain.
If the turbinates are reduced in size or even completely removed during an operation, the message to the brain, the sense of smell and taste and, as already mentioned, the humidification of the air is impaired. This results in both physical and psychological symptoms.
Causes
The cause of the Empty Nose Syndrome is always a previous improper turbinate reduction. Such surgical interventions must be performed when there is chronic enlargement of the turbinates. Enlarged turbinates obstruct the passage of air through the nose.
Reasons for the enlargement can be allergic reactions, inhalation of dusts, smoke or irritants, hormonal disorders, curvature of the nasal septum or constant use of nasal drops with a decongestant effect. During the operation, the nasal passage is widened so that nasal breathing can function unhindered again.
However, after these interventions it was often observed that nasal breathing was still impeded. Because of the empty nasal cavity, turbulent flows occur in the nose and thus flow resistance, which leads to a reduction in air transport through the nose. Because of this, the feeling of nasal congestion arises.
Furthermore, due to the changed aerodynamic processes, the upper parts of the nose are less ventilated, which leads to an impairment of the sense of smell. The nasal mucous membrane contracts and produces much less mucus, so that inhaled pollutants are no longer removed and can therefore accumulate in the nasal cavities.
The dry air causes crusts to form in the nasal cavity, which bacteria can target. A greasy coating can form in the nose, which leads to what is known as the ozaena. Unpleasant, sweetish, putrid smells emanate from the stinky nose.
Symptoms, ailments & signs
Overall, an empty nose syndrome is characterized by a variety of physical and psychological symptoms. There is the subjective feeling of not getting enough air, although objectively this does not correspond to the facts. The air you breathe appears cold and dry.
Furthermore, too little or in some cases too much mucus is produced. The nose can constantly drip, while thick mucus in the back of the nasal cavity gets into the throat. A crust formation in the nose is typical. The sense of smell is severely restricted. There is often pain and pressure in the sinuses, and sinusitis cannot be diagnosed.
Obstructed nasal breathing often affects sleep. Due to the bacterial colonization of the incrustations, a sweetish, putrid smell often flows out of the nose and mouth. Symptoms also include headache or, in some cases, nosebleeds. As a result of these impairments, psychological symptoms such as depression, feelings of fear, concentration disorders, nervousness, constant tiredness and exhaustion can develop.
Diagnosis
The Empty Nose Syndrome is diagnosed on the basis of the symptoms that occur after surgery to reduce the turbinate.
Complications
In the case of empty nose syndrome, breathing through the nose is severely impeded because the turbinates have been completely removed or greatly reduced in size. As a rule, the patient can still breathe the same amount of air through the nose as before the operation.
However, those affected can get the impression that the amount of air is too low and that the person concerned does not get enough air. The lack of turbinates also gives the feeling that the air is cold and dry. Those affected often complain of a permanently runny nose and crust formation around the nose. Sinus infection can also occur.
In many cases, the feeling that you are not getting enough air can lead to insomnia and headaches. Sudden nosebleeds can also occur. The symptoms severely limit the patient’s everyday life and significantly reduce their quality of life. Depression and anxiety can also occur.
Some patients also complain of nervousness. Treatment itself is done with the help of sprays that can relieve symptoms. In order to permanently combat the Empty Nose Syndrome, however, a surgical procedure is necessary. There are no complications.
When should you go to the doctor?
The Empty Nose Syndrome definitely requires medical evaluation and treatment. Difficulty breathing, mucus production disorders and a severely restricted sense of smell are typical complaints that need to be investigated. If an ENS is found in the course of this, rapid treatment is required. A surgical procedure is usually carried out, which is associated with a hospital stay of several days. Close monitoring is necessary after the end of treatment, as this is the only way to rule out complications.
If you experience symptoms such as a persistent runny nose, crust formation, or sinus infection, you should go to the nearest hospital. It is also best to seek medical advice immediately if you have a sudden nosebleed, severe headache, or difficulty sleeping. Should depression or anxiety occur, a therapist can be called in in consultation with the family doctor.
The Empty Nose Syndrome mainly affects people who suffer from an allergy, who breathe a lot of dust, smoke or other irritants due to their work, or who have a curvature of the nasal septum. Hormonal disorders and the regular use of nasal drops can also be triggers. Patients at risk with the symptoms mentioned should definitely consult a general practitioner.
Treatment & Therapy
There are two therapeutic options available. Both non-operative and operative therapy methods are used. The non-surgical treatment methods are aimed at symptomatic therapy. However, only the surgical correction of the turbinates promises lasting healing success.
Non-surgical methods include daily nasal rinsing, using seawater nasal sprays, drinking a lot, using air and room humidifiers, using expectorants, staying in areas with a marine climate, avoiding harmful environmental influences, building up a better bacterial flora in the nose with special nasal drops such as Symbioflor 1.
Sleep masks with a humidifier are also used. During the surgical treatment, the missing turbinates are replaced with appropriate implants. These implants are built from the body’s own bone and cartilage fragments or from artificial materials. Hydroxyapatite cement, Alloderm or silicone can be used as an artificial material.
Outlook & forecast
Unfortunately, up to now there has been little chance of a cure for the empty nose symptom. The respiratory epithelium destroyed in previous operations cannot be replaced. At the moment it is only possible to make breathing easier through the nose by performing another procedure. Yet another operation also carries the great risk of further irritating the mucous membranes. In addition, many doctors only operate on very severe breathing restrictions with the empty nose symptom, as they do not want to cause any further scars.
Those affected can only alleviate their symptoms, such as dry mucous membranes, difficulty breathing and itching, among other things. Nourishing saltwater nasal sprays can help here. But warm nasal showers and ointments also help to moisten the dry mucous membranes again for a short time. Especially in winter, with dry heating air, those affected have to carry out their care routines several times a day. To facilitate breathing through the nose, special inhalations with ointments are useful.
Without treatment of the heavily stressed mucous membranes of the nose, fine tears can occur with the empty nose symptom. These can be associated with very light nosebleeds at first, and later severe nosebleeds. Pathogens can now penetrate through the roughened and cracked mucous membrane of the nose, whereby the risks for chronic rhinosinusitis and other diseases of the nasal mucous membranes are very high.
Prevention
Before a planned turbinate reduction, it should be checked whether there are other treatment options. But even with a necessary surgical reduction of the turbinates, there are ways to prevent empty nose syndrome. This is done, among other things, through the use of minimally invasive nasal and sinus surgery, which is supported by the use of state-of-the-art technologies.
Aftercare
The Empty Nose Syndrome is generally not viewed as a disease, but rather as a disorder resulting from the surgical reduction of the nasal concha. Conventional therapy seeks to artificially moisten the nose, which, according to those affected, feels dry to the touch. In Empty Nose Syndrome, dryness often leads to breathing problems and other complaints.
In the postoperative follow-up care of the Empty Nose Syndrome, patients can do a lot for themselves. You should be by the sea as often as possible, where the salty aerosol at the water’s edge moisten your nose. Daily rinsing of the nose or inhalations with salt water are also helpful, especially during the heating season.
Much can be said against decongestant nasal sprays. Natural salt water nasal sprays are a better alternative for the Empty Nose Syndrome. In addition, ointments with depanthenol and special nasal oils can be used to counteract the perceived dryness. These agents also moisturize the inside of the nose for a long time.
The fact that those affected drink two to three liters of water a day protects the dry-looking nasal mucosa in Empty Nose Syndrome from actually drying out. Humidifiers can be used during the heating season so that the room air never falls below the tolerable level. The degree of humidity that does not lead to mold exposure and is perceived as pleasant varies from person to person.
You can do that yourself
In the case of empty nose syndrome, the turbinate is no longer able to properly moisten the air inhaled through the nose, usually due to a surgical procedure. The syndrome often occurs after cosmetic surgery, but it can also be the result of medically necessary corrections to the nose area.
The best self-help measure is prevention. In the case of cosmetic surgery, the patient should be fully informed about possible risks and weigh up whether he would like to accept long-term damage such as Empty Nose Syndrome. In the case of medically required interventions, other forms of therapy can be tried first.
If an operation is unavoidable, the patient should definitely seek out an experienced specialist who is able to perform a minimally invasive procedure using the latest laser or radio frequency surgical techniques. These surgical techniques maintain the functionality of the turbinate. The medical associations and health insurance companies can help you find a qualified surgeon.
If empty nose syndrome has already occurred, the patient can take a number of self-help measures to alleviate the symptoms. Permanent stay in dry air must be avoided at all costs. A humidifier should be installed in work rooms or at least ventilated regularly. At night it helps to sleep with the window open or to set up a humidifier in the bedroom. Also nasal irrigation with salt water and the use of sea water nasal spray can improve the symptoms.
