Patient history · Nasal surgery · Empty Nose Syndrome
Jack Ackland and Empty Nose Syndrome: A Life Changed by Turbinectomy
Jack Ackland hoped nasal surgery would relieve his sinus pain and allow him to continue training as a military pilot. Instead, the operations were followed by lasting disability, chronic illness and profound psychological distress. Decades later, his son’s investigation connected that history with a condition now known as Empty Nose Syndrome.
Based on journalist Len Ackland’s account of his father’s life, correspondence and medical history, published by Reveal.
Jack Ackland’s Military Flight Training and Sinus Problems
During World War II, Jack Ackland wanted to become a fighter pilot. Sinus problems stood in the way. Changes in pressure during flying aggravated his symptoms, producing frontal pressure, facial pain and the difficulties described in his history as barometric sinusitis.
Jack initially resisted surgery. According to the account assembled by his son, however, pressure from military superiors and the hope of remaining in flight training eventually persuaded him to consent. He expected treatment to help him return to the air.
The outcome was very different. His symptoms persisted, further operations followed, and the resulting disability brought his ambition to fly to an end.
Nasal Surgery in 1943: Submucosal Resection and Turbinectomy
Consent under pressure
Jack was placed under the care of Major R. W. Wright, the head of the hospital’s ear, nose and throat department. In correspondence later examined by Len Ackland, Jack described his reluctance to undergo sinus surgery and the pressure that preceded his agreement to a submucosal operation.
The surgical history describes removal of nasal cartilage and bone, followed by surgery on the turbinates. Wright reportedly believed that infection involving these structures could contribute to ear problems.
Turbinate removal and lasting nasal damage
The first operation took place in March 1943. Len’s account describes extensive removal of supporting nasal structures, subsequent nasal collapse and resection of the ends of the turbinates. An enlarged nasal cavity and atrophic rhinitis were among the consequences described. Jack’s surgical history also included a later Caldwell–Luc operation.
Other doctors questioned the treatment. According to the account, some regarded the surgery as unnecessary. Yet the precise reasoning behind the extent of Wright’s resections remained unresolved in Len’s investigation.
Why Jack could no longer continue flying
In a March 1952 letter, Jack recalled that Majors Wilucki and Neff in Tucson had expressed doubts about his ability to continue flying, while allowing him an opportunity to try.
He tried, but the pain worsened in flight. The symptoms that had troubled him before his hospitalization in Santa Ana remained severe enough to prevent him from flying. His account describes being grounded, reduced to the rank of private without prejudice and sent to Amarillo for reassignment.
Empty Nose Syndrome After Turbinectomy: Understanding the Connection
To understand his father’s surgical history, Len Ackland asked Dr. Robert M. Meyers, an ear, nose and throat professor at the University of Illinois in Chicago, to review the details and consequences of the operations.
According to Len’s account, Meyers explained that Jack’s condition would now be described as Empty Nose Syndrome (ENS). This was a retrospective interpretation of his history, rather than a diagnosis recorded under that name during Jack’s lifetime.
Why an open nasal passage may still feel obstructed
ENS illustrates why nasal function cannot be judged by the size of the airway alone. Changes to turbinate tissue can affect the way inhaled air is conditioned and perceived. Some patients experience distressing breathing sensations even when the nasal cavity appears open. The mechanisms remain under investigation. Read the clinical overview of ENS.
In Jack’s history, the significance of the later ENS interpretation lies in its recognition of physical dysfunction after surgery. His suffering involved far more than the original sinus complaint: persistent pain, repeated illness and a profound loss of everyday functioning shaped the years that followed.
Chronic Illness and Disability Following Nasal Surgery
The severe illness of 1946
In November 1946, Jack was hospitalized with sinusitis and a streptococcal throat infection. His account describes acute rheumatic fever, very high temperatures and severe joint swelling. His appearance changed so dramatically that his wife struggled to recognize him.
Jack credited Dr. Brenann and the medical team with helping him survive. By Christmas Day, his wife was told that he was expected to live.
Medical evidence supporting his disability claim
After this illness, Jack sought an increased disability rating from the Veterans Administration. He and his civilian doctors argued that chronic bronchitis associated with his continuing sinus problems should be considered alongside his sinusitis. The claim was rejected, despite supporting medical evidence.
Dr. E. R. Fenton, who reported treating Jack regularly since December 31, 1943, described persistent drainage from the sinuses, a severe bronchial cough, bronchopneumonia, pleurisy and subsequent infectious arthritis. In his assessment, Jack’s disability was permanent and total. He recommended retirement from official duties and relocation to a warm, dry climate.
The effort required to keep working
Jack continued working while struggling with violent headaches, recurrent sore throats, arthritis attacks, weight loss, weakness and respiratory illness. In his correspondence, he attributed these difficulties to his disability.
“It is often necessary for me to lie down immediately after work so that I can show up the next day...”
His colleagues also described the strain. At times he appeared close to collapse when leaving the office for home or hospital treatment. On other occasions, the pain became so severe that his wife had to collect him and drive him home.
Chronic Pain, Psychological Distress and the Impact on Family Life
Jack’s illness affected his relationships as well as his physical health. His family witnessed increasing withdrawal, irritability and depression. The effort of enduring pain and repeated illness made participation in everyday family life progressively harder.
Another hospitalization in March 1961 deepened his isolation. Being placed apart from others left him feeling that he was contagious to family and friends. The account describes his growing distress and his fear that he had become a burden to those he loved.
A family’s loss in 1961
Len recalled that his father was too ill to join a family visit to Elitch Gardens on Father’s Day, which also marked his younger brother’s sixth birthday. The following morning, his mother woke him after discovering that Jack had not returned home.
Len went out to search for him and found the family car. Jack had died by suicide. His death followed roughly eighteen years of illness after the wartime operations and left his wife and children facing an enduring loss.
The later investigation documented the relationship between his chronic physical illness and psychological deterioration. It also preserved the family’s experience of watching someone they loved struggle to sustain work, relationships and ordinary daily life.
VA Compensation: His Widow’s Fight for Recognition
The VA initially ruled that Jack’s suicide was not connected to his military service or his recognized chronic disability. His widow appealed.
Her appeal described the practical consequences for their children. Earning $4,040 a year, she struggled to support the family and safeguard their education. She emphasized that she was seeking help for their future, not attempting to obtain money dishonestly.
The decision was reversed eleven months later
Eleven months after Jack’s death, the VA changed its ruling. According to the decision quoted in Len’s account, the evidence showed a marked personality change, behavioral disturbances and psychiatric symptoms associated with an acquired mental disorder.
The agency recognized that this disorder was present at the time of his suicide and was directly related to the consequences of sinusitis and bronchitis.
The decision provided financial support and acknowledged a connection the family had fought to establish. It could not restore Jack’s health or undo the loss of a husband and father.
Len Ackland’s Investigation into His Father’s Nasal Surgery
In his 2018 article, journalist Len Ackland revisited the medical treatment and institutional decisions that had shaped his father’s life. Letters, accounts from doctors and the family’s memories helped him reconstruct the years between the wartime operations and Jack’s death.
One question remained unresolved: why had an experienced surgeon undertaken such extensive resections? Len considered whether the result reflected deliberate surgical choices, mistakes or the pressures of wartime medical practice, but he could not establish Wright’s reasoning.
Meyers’ later review offered a modern clinical framework for understanding the postoperative nasal condition. The surviving correspondence documented its human consequences: the loss of flying, repeated illness, difficulty maintaining employment and a prolonged struggle for recognition.
Jack’s history remains relevant to discussions of nasal surgery because it connects surgical outcomes with the life a patient must lead afterward. Preserving nasal function, recognizing persistent symptoms and taking the consequences of chronic disability seriously are central to that discussion.
Read Len Ackland’s full article at Reveal or open the linked PDF copy .
Marcio Goulart: A Later Account of Suffering After Turbinate Surgery
Later patient accounts show why the consequences of turbinate surgery continue to concern ENS communities. One such account concerns Marcio Goulart in Brazil.
The community account describes severe suffering after a turbinectomy approximately two years before his death in April 2020. It reports that nearly all of his turbinate tissue had been removed and associates his subsequent distress with Empty Nose Syndrome. These details come from the patient and community narrative.
A message attributed to Mari Garb on the Empty Nose Syndrome Awareness Forum, dated April 26, 2020, announced his funeral in Minas Gerais, Brazil, and expressed sympathy for his family.
“May we bring prayers and a lot of light to him and his family in this sad moment of farewell.”
Jack and Marcio lived in different countries and generations. Their stories are remembered within ENS communities for the suffering described after surgery and for the families left behind. They underscore the importance of recognizing both physical symptoms and psychological distress when patients report serious postoperative difficulties.
Sources and Further Reading
- Len Ackland, Reveal: How an honorable discharge led to a life of pain for a WWII vet . The journalistic account underlying Jack’s story and the correspondence discussed here.
- Linked document: PDF copy linked with Jack Ackland’s story .
- Cleveland Clinic: Empty Nose Syndrome . Medical background on symptoms and postoperative nasal dysfunction.
- Cleveland Clinic: Atrophic Rhinitis . Medical background on nasal tissue changes, dryness and crusting.
- Patient and community account: Marcio Goulart’s Story with Empty Nose Syndrome .
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