onsdag 12 juni 2024

Empty Nose Syndrome - The Dark Side of ENT Surgeries: Marcio Goulart’s Story

Patient experience · Empty Nose Syndrome · Brazil

Marcio Goulart, born on October 9, 1988, was a Brazilian English teacher whose life changed dramatically after septoplasty together with extensive turbinate and sinus surgery in 2018. The preserved account describes severe postoperative breathing distress, paradoxical obstruction, sensations of suffocation, panic attacks, major functional loss and an international search for help. Marcio died by suicide on April 21, 2020.

Content note: This page discusses severe illness, psychological distress, a previous suicide attempt and death by suicide.
Source context: This page preserves several different types of material: Marcio's own video testimony, a close friend's account, surgical information, postoperative images and comments from members of the Empty Nose Syndrome community. Statements made by friends or community members are presented as testimony or opinion and should not be read as independent medical or legal findings.
Marcio Goulart, Brazilian Empty Nose Syndrome patient after septoplasty and extensive turbinate surgery
Marcio Goulart. Image preserved with the original case material.
NameMarcio Goulart
BornOctober 9, 1988
CountryBrazil
OccupationEnglish teacher
Nasal surgerySeptoplasty with extensive turbinate and sinus surgery, 2018
Passed awayApril 21, 2020

Marcio Goulart Before Septoplasty and Turbinate Surgery

Before the surgery, Marcio was a successful English teacher in Brazil and was described by friends as having a happy and fulfilling life. According to the preserved testimony, his health and ability to function changed severely after the 2018 nasal operation.

The original case material states that the operation involved an almost total bilateral reduction or removal of the inferior turbinates together with septoplasty, and repeatedly gives a figure of approximately 90% of the inferior turbinate tissue on each side. That percentage comes from the preserved patient and friend account; the surgical material reproduced farther down the page should be read separately from that estimate.

After the operation, Marcio described a persistent sensation of obstruction despite a surgically enlarged nasal cavity. He repeatedly compared breathing to trying to inhale through very small straws. This kind of mismatch between an open nasal passage and a powerful sensation of blockage or suffocation is one of the features commonly discussed in relation to Empty Nose Syndrome (ENS).

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Severe Empty Nose Syndrome Symptoms After Surgery

The preserved account describes daily sensations of suffocation, panic attacks and severe difficulty with ordinary physical activity. Marcio reportedly could barely walk without feeling that he was choking. His description of an apparently open nose that nevertheless felt continuously obstructed became a recurring part of his discussions with other ENS patients.

Paradoxical obstructionPersistent feeling that the nose was blocked despite extensive surgical opening.
Suffocation and air hungerDaily sensations of not being able to breathe normally.
Panic attacksFriends described recurrent panic in connection with the breathing distress.
Severe exercise limitationHe was reported to struggle even with walking without feeling choked.
Loss of work capacityThe friend account states that he had to stop working as an English teacher after surgery.
Persistent pain and distressHe repeatedly told friends and forum members how much he was suffering.
Archived screenshot documenting Marcio Goulart's Empty Nose Syndrome case
Archived material preserved with Marcio's case.
Archived Empty Nose Syndrome discussion related to Marcio Goulart
Additional archived material from the original page.

The broader medical context of symptoms reported after turbinate procedures is discussed in the site's guide to nasal surgery risks, septoplasty, turbinate reduction and Empty Nose Syndrome.

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Marcio's Search for Help and ENS Reconstruction

Despite the severity of his condition, the preserved account says that Marcio felt that his family did not take the illness seriously. He sought help from different doctors and became active in Empty Nose Syndrome forums, where he searched for information, support and possible reconstructive treatment.

According to his friend's testimony, Marcio travelled to Italy to see Dr. Fabio Piazza about implants. The account states that Dr. Piazza did not recommend operating because of concern that another procedure could make Marcio feel even more obstructed. Marcio was described as deeply distressed after this consultation and later survived an initial suicide attempt.

He also explored the possibility of receiving implants from Dr. Das. Money and travel costs were reported to be significant barriers. His experience illustrates why reconstructive options are a major topic among ENS patients; a separate article on this blog compares reconstructive approaches and implant materials used in Empty Nose Syndrome.

Marcio Goulart with his mother, image preserved in the Empty Nose Syndrome case archive
Photograph preserved with the original testimony about Marcio Goulart.
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July 16, 2020: A Close Friend's Testimony About Marcio Goulart

The following testimony was preserved on the original page from a friend who said that he and Marcio spoke every day. It is retained because it contains detailed information about Marcio's symptoms, search for treatment, work loss and participation in ENS forums.

“Hello, yes, I knew Marcio. We called each other every day. He was a very kind and humble person, it was very pleasant to talk with him. He suffered a lot. Every day, he was suffocating and had panic attacks. He was unable to walk without choking. They had removed, on each side, 90% of his lower turbinates. He went to Italy to see Dr. Piazza for implants, but Dr. Piazza refused to operate on Marcio fearing that Marcio would become more obstructed based on what Marcio had told Dr. Piazza regarding his symptoms. Marcio became very depressed after his consultation and shortly after unfortunately attempted suicide. He was able to survive this suicide attempt.

Marcio was very active on the Empty Nose Syndrome forums. He interacted with a lot of people. He was trying to see if he could get implants with Dr. Das, but money and travel cost were an issue. He always told me how much pain he suffered and what a normal life he had before, as an English teacher in Brazil. He was ‘very successful’ before his septoplasty and turbinate reduction surgery. After the operation, he was forced to quit his job and became permanently disabled. He compared his breathing to that of a person who breathed all day through a straw with a feeling of permanent obstruction.

His family did not take his condition seriously at all. He always told me he didn't know what he was going to do. Unfortunately, he bought a gun from someone who he met online. He told me about it and a few others too. He hid the gun somewhere in his house and one evening he took it and shot himself in the head. There was nothing I could do to stop it. He had gone on Facebook to say goodbye to this cruel world before pulling the trigger. The ENS community was devastated. Marcio was very popular with everyone in the groups. It was a shock for all of us. Marcio could no longer bear the terrible suffering, nor accept his condition.”

Archived screenshot accompanying a friend's testimony about Marcio Goulart
Archived social media material about Marcio Goulart and Empty Nose Syndrome
Additional archived Empty Nose Syndrome community material related to Marcio Goulart

The psychological burden associated with severe ENS is discussed separately in the evidence-focused article Empty Nose Syndrome, Severe Psychological Distress and Suicidal Thoughts After Turbinate Surgery.

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Video Testimony: Marcio Goulart and Empty Nose Syndrome

The video below was included on the original page as part of the record of Marcio's postoperative experience. It is preserved as patient testimony about the consequences he associated with turbinate reduction and septoplasty.

Watch the same Marcio Goulart video directly on YouTube.

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Marcio Goulart's Surgical Procedures: Septoplasty, Turbinoplasty and Sinus Surgery

The archived material identifies Marcio's surgeon as André Luiz Gomes de Araújo and gives the following hospital information:

Hospital UNIMED Vale do Aço
Rua Ipanema, 86
Centro - Coronel Fabriciano/MG
CEP: 35170-032

The original page described the following procedures from the surgical report:

  • Right frontal sinus surgery and left ethmoid surgery
    Procedure: sinusectomy. Method: videoendoscopy. Technique: aspiration via the frontal recess.
  • Left sphenoid sinus surgery
    Procedure described in the archive as “ethmoidectomy with media,” together with turbinoplasty.
  • Turbinoplasty
    The surgical material lists turbinoplasty among the procedures performed.
  • Additional sinusectomy
    Method: videoendoscopy. Technique: aspiration via the natural ostium.
Surgical report excerpt from Marcio Goulart's nasal and sinus surgery
Excerpt from the surgical material reproduced on the original page.

Summary of the surgical information

The archived report describes right frontal sinus and left ethmoid surgery involving sinusectomy performed with videoendoscopy and aspiration through the frontal recess. It also describes left sphenoid/ethmoid surgery together with turbinoplasty, and an additional sinusectomy performed endoscopically through the natural ostium.

In the context of Empty Nose Syndrome, the central concern raised by the case material is the extent of postoperative change in the turbinate region and how that anatomical change corresponded in time with Marcio's severe breathing symptoms.

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Postoperative Nasal Anatomy and Empty Nose Syndrome Concerns

The original page included the image below to illustrate how open Marcio's nasal cavity appeared after surgery and described the inferior turbinate region as extensively reduced. The page associated this postoperative anatomy with the development of Empty Nose Syndrome and with Marcio's persistent sensation of suffocation and obstruction.

Postoperative nasal image from Marcio Goulart's case showing a very open nasal cavity after turbinate surgery
Postoperative image preserved in the Marcio Goulart case archive.
Original editorial wording preserved in context:

The earlier version of this page described turbinate reduction polemically as a “new era lobotomy” and used the phrase that the surgeon had “butchered” Marcio's nose. Those expressions are part of the original advocacy text and reflect the author's condemnation of the outcome; they are not medical or legal determinations.

The original article argued that Marcio's case should raise awareness of the potential seriousness of complications after turbinate surgery, particularly when patients report paradoxical obstruction, suffocation, loss of normal airflow sensation and major functional decline. It also criticized what the author viewed as inadequate warnings before surgery and the tendency for some postoperative complaints to be interpreted primarily as psychological.

The original text further alleged that financial incentives can influence how turbinate procedures are presented and asked when surgeons would be held accountable for devastating outcomes. Those are advocacy claims from the original page, not findings established here. The broader evidence on ENS, nasal airflow, sensory function and turbinate surgery can be explored in the blog's Empty Nose Syndrome research library.

Archived Empty Nose Syndrome community material related to Marcio Goulart's postoperative outcome

At the time the original page was compiled, the site's archive stated that Marcio's death was one of 46 suicides and 8 non-fatal attempts it had registered following turbinate reduction surgery. This is a count reported by the site's own archive rather than an epidemiological estimate of suicide risk.

Readers looking for the wider collection can continue to the Empty Nose Syndrome patient case archive and severe outcomes.

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Comments From the Empty Nose Syndrome Community

The original page preserved comments from Marcio's YouTube channel and ENS-related Facebook or forum discussions. They are reproduced below as community reactions and personal opinions.

Person 1: “Thank you so much for your video Marcio. We love and miss you forever. Thank you for being one of the gentlemen, the most kind and understanding human being. I am so sorry for all the suffering you endured. We'll all be reunited someday. Heaven gained another beautiful angel. You will forever be missed & live in our hearts. Until we talk and meet again.”
Person 2: “Hello Marcio. it's (name protected). Great video, don't give up my friend, you have been given a tough road like me, but it will also be the making of you as a person, if you can get through this, you can get through anything.”
Person 3: “Marcios surgeon killed Marcio. If his surgeon did not remove Marcios inferior turbinates, Marcio would not have suffered tremendously with ENS and he would not have had to end his life.”
Person 4: “Sad, we love, I love you, I can understand you. My brother be brave.”
Person 5 — Ensaerodynamics: “Marcio this is so sad. I too have ENS and I have seen far too many people kill themselves over this sad surgically caused condition. More people need to be made aware of how dangerous turbinate surgeries are. These ENT doctors do not know the scope of their craft. They don't know where the nerves are. Their research on turbinate reduction has been shoddy and has produced decades of conflicting results. To how much to remove or where. They are guessing which is experimenting on humans! Some remove middle turbinates, some inferior, some burn them, use lasers, RF and all matter of resection procedures, even during septoplasty procedures. I know because I have lived it and struggled with ending my life as well. Instead, I was lucky enough to find a good doctor to rebuild the inside of my nose with implants. learned to model airflow and have posted my results here for anyone who wants to know exactly how totally destructive many ‘common’ nasal surgeries actually are: emptynosesyndromeaerodynamics.com
Person 6: “Marcio was a very close, good friend of mine. May God have mercy on your soul. Love you man. You were the best. The most kind, caring, honest person you could ever talk to. He has passed away. He was brain dead at first but he has now passed away. It breaks my heart. I was very close to him. For those of you who don’t know he committed suicide on the morning of April 21, 2020, like yesterday.”
Person 7 — April 28, 2020: “In April of 2020 ENS victim Marcio Goulart took his own life because he could no longer tolerate the unbelievable suffering caused by his grotesquely incompetent surgeon who removed just about all his turbinates two years ago. Does anyone have the name and contact info for this surgeon? I want everyone to call and email this surgeon demanding that he pay Marcio's mother for ALL funeral expenses in addition to compensation for the unbelievable pain and suffering she is dealing with. This surgeon is a monster who must be held financially responsible for what was done to such a beautiful and caring soul.”
Person 8 — April 26, 2020: “Hi, I come to inform you that the funeral and funeral of our dear friend Marcio is scheduled for 3 pm, in the state of Minas Gerais in Brazil. May we bring prayers and a lot of light to him and his family in this sad moment of farewell.”

These quotations document how members of the ENS community reacted to Marcio's illness and death. Statements accusing individuals of responsibility are the opinions of the quoted commenters and are not presented by this page as adjudicated facts.

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Full Source Document and Archived Material About Marcio Goulart

The embedded document below contains the collected material preserved for Marcio's case. It can be viewed directly on the page; the original document viewer also provides its own print or download controls where available.

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