The research article presents a systematic review of the pathophysiology of Empty Nose Syndrome (ENS), a condition characterized by paradoxical nasal obstruction and a sensation of emptiness in the nasal cavity, often following surgical interventions aimed at relieving nasal obstruction. The review aimed to consolidate existing knowledge regarding the mechanisms underlying ENS, which remain poorly defined despite significant research efforts.
The authors conducted a comprehensive search of the literature, yielding 2,476 studies after removing duplicates. Ultimately, 19 studies were included in the qualitative analysis. These studies varied in design, including case-control and cross-sectional studies, and involved a total of 489 adult patients diagnosed with ENS. The definition of ENS varied across studies, with some relying on self-identification, while others used specific questionnaires like the Empty Nose Syndrome 6 Questionnaire (ENS6Q) or defined it by the presence of paradoxical obstruction.
Key findings from the review highlighted several important themes:
Symptomatology: Patients with ENS reported a range of symptoms, including nasal obstruction, dryness, and a lack of sensation. The severity of these symptoms was often comparable to those experienced by patients with chronic rhinitis, indicating a significant impact on quality of life.
Mental Health: A notable correlation was found between ENS symptoms and mental health issues, such as anxiety and depression. The burden of these psychological conditions was significant, with some patients experiencing severe distress and a diminished quality of life.
Anatomical and Physiological Changes: The review noted that while patients with ENS often had a patent nasal airway, structural changes in the nasal cavity could still be present. However, the relationship between these anatomical changes and the symptoms of ENS was not straightforward, as many patients did not exhibit typical signs of nasal obstruction.
Airflow Dynamics: The influence of altered airflow on the perception of nasal patency was discussed, with some theories suggesting that changes in airflow dynamics could contribute to the sensation of emptiness experienced by ENS patients.
Neurosensory Dysfunction: The review also explored the possibility of neurosensory decline, where patients may have an altered perception of nasal sensations, leading to the symptoms associated with ENS.
Psychogenic Factors: Psychogenic dysfunction was identified as a potential contributor to ENS, with some patients experiencing heightened awareness of their symptoms, which could exacerbate their condition.In conclusion, the systematic review underscored the complexity of ENS, revealing that it is not merely a result of anatomical changes following surgery but is also influenced by psychological, sensory, and airflow-related factors. The findings emphasize the need for a multidisciplinary approach to understanding and managing ENS, considering both the physical and psychological aspects of the condition. The authors advocate for further research to clarify the pathophysiological mechanisms of ENS and improve diagnostic and therapeutic strategies for affected patients.
Over three decades have passed since Dr. Eugene Kern first identified Empty Nose Syndrome (ENS), yet the number of people developing this condition post-septoplasty, sinus surgery, turbinate reduction, rhinoplasty, and spreader graft surgery continues to rise.
Now let's start the video by listening shortly to What Eugene Kern has to say about the condition
Since the 1980s, improvements in endoscopic cameras have led to the development of various instruments for turbinate reduction. Medical device manufacturers have mass-produced tools for Coblation, Radiofrequency, and Laser Ablation, aiming to maximize profit.
One instrument after another has been increasingly effective at destroying and shrinking the nasal turbinates. Unfortunately, this process has completely disregarded the fact that nerves, receptors, blood vessels, cilia, and goblet cells are destroyed in the process. When a significant number of these receptors are damaged, the individual loses the ability to sense airflow in the nose, leading to a constant fight-or-flight response. The nose also becomes severely dry, and over time, the nasal mucosa may degenerate into a condition known as atrophic rhinitis.
Furthermore, these processes open up the nose to an abnormal level where the lungs don't get enough air resistance in the nose to inflate fully. Air flows in and out too fast without proper nasal resistance, causing hyperventilation and severe problems with gas exchange in the lungs. For example, we have seen a case where an overly open nose led to nightly hypoventilation and carbon dioxide poisoning.
Advancements in technology have led to an increase in nasal surgeries for congestion, turning them into routine practice. Despite numerous reports of adverse outcomes, the medtech industry and ENT surgeons are hesitant to confront these problems. Their main concern seems to be maintaining business operations rather than ensuring patient health. To protect the ENT field, surgeons are quick to attribute complications to poor healing or dismiss them as psychological issues. While some surgeons may be uninformed, most are aware of the essential role nasal turbinates play; they just keep quiet to not reject potential income.
Unfortunately, it is becoming more common for these surgeries to lead to suicides due to severe suffering. One would think that suicides linked to ENS would lead to a reevaluation of nasal surgeries, but this has not been the case. Whether there are ten or thousands of suicides, surgeons appear indifferent as long as their practice is not affected.
Now, let's listen to yet another ENS-related death. This is the testimony of Robert Priscilla, who passed away on August sixth, 2015, due to Empty Nose Syndrome.
Everything started in 2009. I suffered from sinus infections all year long. While on sick leave, my doctor referred me to specialists, an allergist and an ophthalmologist, because of severe eye pain. It turned out I also had asthma. Eventually, my general practitioner sent me to an ENT specialist who diagnosed swollen turbinates. Initially, he suggested laser treatment. In March, I underwent the procedure to burn the turbinates. Unfortunately, I didn't notice any improvement in my breathing post-surgery.
Four weeks later, I returned to the ENT specialist, still dissatisfied with my condition. He then recommended removing the lower turbinates and performing a septoplasty to correct my nasal septum. The surgery took place in April, followed by nasal packing. The next day, I experienced a minor hemorrhage from my left nostril after the packing was removed. Despite assurances from the nurse that I should be able to breathe better, I continued to face obstruction. The pain in my nose intensified, and my headaches worsened. Anxiety attacks became frequent, and I struggled to stand due to severe discomfort.
The situation escalated to the point where I needed emergency care. However, the on-call ENT specialist refused to acknowledge any connection to my recent surgeries. After discharge, I sought a second opinion, only to be turned away due to concerns over a colleague's work. In desperation, I traveled to Paris for a third opinion and underwent a sleep study revealing poor sleep quality, snoring, and atrophic rhinitis.
Since 2011, my life has been a nightmare. I barely eat, and I can no longer sleep. I've lost my sense of smell, and my nose is even more blocked than before the surgeries. Exertion is nearly impossible. I live in constant hyperventilation with a perpetually dry nose. The cold burns, and even speaking is excruciating. Pressure from my nose to my forehead feels like my head is being crushed. Lying down is torture; I feel like I'm suffocating. I am utterly exhausted, isolated, and deeply depressed. This is not how someone my age should live, it's not living at all.
My condition has only deteriorated since the surgeries. Had I known the risks, I would have never consented. I found solace in an association that provides emotional support, though many countries don't recognize this syndrome. Why? I share my story hoping others can avoid my suffering. The laser treatment and turbinectomy destroyed my life. Once active and engaged, I am now confined, semi-reclined, and condemned to suffer. Only one ENT specialist had the courage to tell me that turbinates never regenerate.
Priscilla Robert’s testimony reminds us that she passed away on August 6, 2015, due to Empty Nose Syndrome. Her story is just one of hundreds of patients whose lives have been irreparably damaged to the point where they could no longer bear to stay alive. More information about Prisilla can be found in the video description.
In memory of Mélisa Champion, who passed away on May 23, 2015, at the age of 33, her parents Marcelle and Jean-Yves Champion share the heart-wrenching story of their daughter’s battle with empty nose syndrome (ENS).
Mélisa was a vibrant, sociable, and friendly individual who pursued a career in tourism with aspirations of becoming a flight attendant. She had a passion for traveling and experiencing different cultures. However, her life took a devastating turn following a medical procedure that was meant to improve her quality of life.
In 2007, Mélisa experienced persistent ear pain while traveling, prompting her to consult a family doctor and subsequently an ENT specialist in Quebec. She was diagnosed with a deviated nasal septum and advised to undergo septoplasty, a procedure to straighten the septum and improve airflow. The ENT specialist assured Mélisa that the operation was straightforward and failed to mention that it would involve not just a septoplasty but a complete septorhinoplasty and bilateral reduction of her inferior turbinates. If Mélisa had been informed about the full extent of the surgery, she would have refused it.
Mélisa's video was recorded approximately December 16th year 2014
The surgery took place on November 11, 2007, and marked the beginning of Mélisa’s prolonged suffering. Initially, she experienced nasal dryness and had to undergo constant and increasingly painful treatments to clear nasal secretions. Over time, she developed severe allergies and asthma attacks due to the rapid passage of unfiltered, unhumidified air through her nasal passages, which now lacked the essential turbinates. She suffered from facial pain, eye pain, ear pain, throat pain, recurring headaches, and a constant feeling of her lungs being "frozen." To alleviate her lung pain, Mélisa resorted to drinking hot water and consuming breadcrumbs
In 2008, Mélisa began receiving allergy vaccines to manage her symptoms, but her condition continued to deteriorate. She lost her job due to her declining health and had to move back home with her parents. By 2013, her symptoms had worsened to the point where she sought further medical advice. In October of that year, she was placed on sick leave due to ENS and was urgently hospitalized in May 2014 for anaphylaxis, a severe allergic reaction that could have been fatal.
In May 2015, another ENT confirmed the grim reality: Mélisa had developed total paralysis of her sinus functions, and her nasal tissues were dead with no possibility of recovery. He advised against any further surgeries due to the severe atrophy of her mucous membranes. Despite the bleak prognosis, Mélisa appreciated the ENT's honesty and understanding.
To survive, Mélisa relied on an AIRVO device, an integrated flow humidifier, which she received in 2014. This machine was essential for her to breathe as it humidified and warmed the air entering her lungs. Without it, the cold, dry air would cause her bronchial tubes and lungs to inflame, leading to prolonged and painful asthma attacks. The constant use of this machine was necessary to manage her unbearable lung pain.
Mélisa’s condition severely impacted her quality of life. She was confined to her home, dependent on the AIRVO device and various treatments to manage her symptoms. Despite her debilitating illness, Mélisa found solace in small moments of happiness with her loved ones, reading, listening to music, and trying to keep herself informed and relaxed.
In her final days, Mélisa expressed a deep acceptance of her situation. She prayed for peace and a place in the afterlife free from suffering. Her parents, Marcelle and Jean-Yves, emphasize that Mélisa's death was due to a long illness and not by suicide, unlike other victims of ENS. They hope that the medical community will recognize ENS to prevent others from enduring the same suffering.
Mélisa’s parents also highlight the financial burden of her condition. Mélisa needed a transplant procedure available only in the United States or Germany, costing over $50,000, including travel, hospitalization, and other associated expenses. Despite efforts to raise funds and seek help, Mélisa did not receive the necessary intervention.
Mélisa Champion's story is a poignant reminder of the importance of informed consent in medical procedures and the devastating impact that ENS can have on a person's life. Her legacy lives on through her parents' advocacy for the recognition and prevention of ENS.
Mélisa was a very sociable and friendly person. She studied tourism to become a flight attendant. She loved traveling and discovering other cultures. When she traveled, she complained of ear pain, which led her to consult her family doctor and then an ENT specialist in Quebec, who suggested septoplasty because her nasal septum was deviated. He never mentioned to Mélisa that she would undergo surgery on her turbinates. He only said that he wanted to make more space in her nose so that air could enter more easily. If Mélisa had been warned, she would have categorically refused such mutilation. When our daughter received her surgery report, it mentioned “complete septorhinoplasty and bilateral reduction of inferior turbinates” (surgery performed in 2007).
A few months after this surgery, she was not doing well and developed several symptoms, the first of which was nasal dryness. To evacuate the secretions, she constantly underwent treatments that became longer and more painful, leading to exhaustion and extreme fatigue. Allergies and asthma attacks followed. In the absence of the inferior turbinates, the passage of air was too rapid, and the air was no longer filtered, warmed, or humidified. She also had facial pain, eye pain, ear pain, throat pain, and recurring headaches. She had lung pain and felt they were "frozen." Mélisa drank hot water and ate breadcrumbs to alleviate her lung pain and no longer had sodium in her blood. From 2008, she received allergy vaccines to desensitize her.
Obviously, the consequences were predictable: job loss, poor quality of life, and moving back to our home. Over time, her condition and quality of life had significantly deteriorated, so much so that she saw her ENT again in September 2013. He noted several symptoms she had developed. In October 2013, Mélisa was on sick leave for empty nose syndrome and was urgently hospitalized in May 2014 for anaphylaxis (a severe allergic reaction that could be fatal).
In May 2015, our daughter met another ENT, and his diagnosis was unequivocal, stating that Mélisa had developed "total paralysis of the sinus function, that the tissues, the sinuses were dead, and there was nothing more to be done." He advised her not to undergo further surgery because her mucosa was severely atrophied. She preferred to know the truth rather than be given false hope. She found this ENT to be humane and attentive: he took the time to explain things to her.
Her nose was so dry and no longer performing a normal respiratory function that she had to live permanently with an AIRVO device (an integrated flow humidifier received in 2014). Without this machine, our daughter automatically suffocated because there was too much air entering, and it was too cold, causing her lungs and bronchi to become inflamed, leading to asthma attacks that could last for hours. She could no longer do without this machine; otherwise, the lung pain was unbearable as if her lungs were in an "ice pack," horrible! She was once again diagnosed with empty nose syndrome by this ENT.
Her friend, Carole, who suffered from atrophic rhinitis following turbinectomy and bilateral cauterization of the inferior turbinates, communicated with and supported her. Carole asked Mélisa what she loved most in life. Here is what Mélisa replied in writing: “Since I am disabled and confined at home, plugged into a machine, I try to appreciate the small moments of happiness with my loved ones and find peace of mind so I can leave peacefully in the near future… I no longer have any quality of life, so what I love, I no longer know because I can no longer do anything! The illness has weakened me to an extreme point! I try to keep busy by reading, listening to music, reading newspapers, staying informed, and taking moments of relaxation without thinking about anything. It feels good.”
Shortly before her death, Mélisa wrote, “I prayed. I asked the Lord to make a place for me beside Him. I know you are waiting for me, and my place is already prepared in your kingdom. To live in peace and without suffering with you, Lord. I let my soul dance towards a new life in love forever because health is the greatest wealth in the world. Amen.”
We hope that this condition, empty nose syndrome, will be recognized by the medical community because we cannot conceive that such an operation could cause so much suffering and lead to the irreparable, the loss of our child.
We also insist on the fact that our daughter died of a long illness on May 23, 2015, at our residence and did not commit suicide like other victims of ENS.
Her parents, who will forever keep Mélisa in their hearts,
Marcelle and Jean-Yves Champion, Canada.
Below you find all the information we have about Mélisa. The document can be downloaded or printed from the bottom right corner
Sherri Ann Cutrona, born sometime between 1962 and 1963, resided in Manchester Township, New Jersey, USA. She passed away on July 16, 2020, at the age of 57. Sherri was originally from Hackensack, New Jersey, she had previously lived in Brick before moving to Manchester Township three years prior to her passing.
Sherri worked as an engineer for Heyco Products in Toms River before retiring. She was active in the Tracheobronchomalacia (TBM) Support Group and in the Facebook group Empty Nose Syndrome Awareness. Sherri Ann had a passion for dancing, cooking, sewing, and cruises.
She is survived by her two sons, Cory J. Speiser of Manchester Township and Shane C. Speiser of Brick, her father Joseph Oles of Toms River, her brother Jeff Cutrona of Toms River, and her sister Cynthia Ronan of South River. Her final wish was to have her ashes scattered at sea.
Sherri Ann Cutrona's story regarding Empty Nose Syndrome
Sherri Ann's journey with Empty Nose Syndrome (ENS) was long and arduous, marked by numerous consultations and treatments with various specialists. She saw Dr. Oren Friedman at Penn in Philadelphia. Dr. Friedman confirmed her ENS diagnosis but unfortunately said there was nothing he could do to help her, except for prescribing Premarin cream, antibiotic ointment, and ordering nasal oil from the Mayo Clinic. Sherri Ann left the appointment feeling disappointed as he mentioned he didn’t need to see her again.
In another consultation, this time over the phone with Dr. Das, he explained that her inferior turbinate’s were removed by about 50%. She wrote that Dr. Das was compassionate and knowledgeable about her numerous health issues, which was a refreshing change for Sherri Ann, who had often felt dismissed by other doctors.
Sherri Ann vented her frustrations about her declining health. Recently, she had a port installed to facilitate her IVIG infusions due to her deteriorating veins. She lamented the myriad of health issues stemming from her turbinate surgery 29 years ago, which had prevented her from living a full life. Her daily struggles and constant crying had worn her down, making her long for just a few days of feeling well.
She sought advice from others about their experiences with implants, especially those who underwent surgery with Dr. Nayak. She was curious about their recovery times and overall satisfaction with the results, hoping for positive feedback. Members of the group reassured Sherri Ann that she was not alone, but she continued to experience severe ENS symptoms. She contemplated getting a new CT scan and sending it to Ohio State University for further evaluation. Despite having implants, she still felt extremely dry, describing it as 'desert dry.
Sherri Ann had endured chronic sinus and respiratory infections for years, which led to severe asthma, GERD/reflux, IGG deficiency, sleep apnea, allergies, and irritable bowel syndrome. A new health crisis came when her trachea and main bronchus collapsed, requiring major surgery to install mesh supports. Doctors attributed these problems to her chronic infections, exposure to burning plastics at work, prolonged steroid use, and Empty Nose Syndrome.
Reflecting on her years of suffering, Sherri Ann realized she had been living with undiagnosed Empty Nose Syndrome for a long time. The condition had worsened with age, and an endoscopic examination revealed the extent of the damage from her previous laser turbinate reduction. The turbinate’s were reduced by 50%. She felt disheartened by the lack of understanding and support she had received over the years. She also told another member that she had severe problems with her sleep. She writes that she never slept again after her sinus surgeries.
Sherri Ann tried an experimental surgery to add nasal implants to create more volume in her nose due to loss of turbinate volume. Dr. Overdevst performed her implants. 4 months after implants she writes there was no improvement. Sherri was also exploring stem cell injections as a potential treatment and had an appointment scheduled. She also had a CFD study performed before her implants. The result can be found further down in the text.
In her correspondence with others in the community, Sherri Ann expressed deep frustration over the lack of effective treatments and research for Empty Nose Syndrome. She felt hopeless at times but continued to find solace in her faith and the support of fellow sufferers. Despite her challenges, Sherri Ann held onto the belief that relief was possible and continued to seek out new medical opinions and treatments.
Sherri Ann passed away July 16, 2020, at the age of 57. From what we know the reason was another lung infection.
When the nose remains wide open and dry without protective mucous membranes, cold, unfiltered air reaches the lungs and can easily carry bacteria and viruses directly down to the lungs. Furthermore, when the nasal mucosa is destroyed and removed, the ability to produce nasal nitric oxide is reduced. This gas is normally antibacterial and antiviral, which could also be a cause of her recurrent lung infections
Sherri Ann's battle with ENS and the complications it caused were relentless, and her loss is deeply felt by the members of the ENS Awareness group. Her story underscores the severe impact ENS can have on one's life and the need for greater understanding and treatment options for those who suffer from it. Sherri Ann lived most of her life without knowing her problems were related to a previous turbinate reduction with laser that had reduced the volume of her turbinate’s by 50%.
Below you will find all the information we have gathered about Sherri Ann Cutrona. In the bottom right corner, you can download or print the document
**The Story of Rachel Jordan: A Struggle for Every Breath**
Rachel Jordan, a woman from the UK, tragically took her own life in 2021. She battled severe nasal and breathing issues that fundamentally impacted her life. Her story, as revealed through her posts in a support group on Facebook, provides a deep insight into her daily struggles and the measures she tried to alleviate her symptoms.
Rachel described how every breath was a struggle. She explained that her nose was so dry and damaged that she couldn't breathe normally through it. There was no functional mucosa left on her septum and inferior turbinates, resulting in a complete lack of sensation and resistance in her nose. This absence of normal breathing function made every breath an effort that she couldn't even feel, leaving her with a constant pounding pulse and dizziness. Her situation became so desperate that she expressed concern about not being able to see her young daughter grow up.
Rachel asked other group members for recommendations on anxiety medications to help manage the constant fight-or-flight feeling that her condition caused. She had previously tried Sertraline (known as Zoloft in the US) but couldn't cope with the initial side effects it caused.
Rachel’s struggle was not limited to her waking hours. She found that her symptoms were particularly severe in the early hours of the morning. She would wake up in a state of extreme anxiety, unable to control her breathing due to the lack of sensation and resistance in her nose. Although she took mirtazapine to help her sleep, she often woke up between 3 and 5 am and couldn’t go back to sleep. Her anxiety remained high throughout the day, accompanied by noisy and difficult breathing, as well as lightheadedness and dizziness. In the evenings, after around 8 pm, she noticed that her turbinates seemed to swell slightly, giving her a bit more sensation and reducing her anxiety somewhat, although the sensation was still unpleasant and noisy.
No matter what she tried, Rachel couldn't get any moisture into her nose. Her septum remained permanently dry, and she wondered if some kind of metaplasia had occurred, leaving her without any functioning mucosa. She tried various remedies, including rinsing, NeilMed, Xlear, Ayr gel, coconut oil, Bapanthem nasal cream, Vaseline, but nothing worked.
Rachel’s symptoms first appeared after years of crusting in her nose, which she used to remove. She had (regrettably) undergone septorhinoplasty to try to solve her airflow problems, but the surgery only made things worse. The inside of her nose was numb, and she had no resistance to her breathing. She couldn’t sense airflow or temperature changes and felt like she couldn’t breathe. She was constantly manually breathing and couldn’t sleep at night without mirtazapine, which only gave her four hours of sleep on a good night. Her nose was bone dry, and she believed that years of crusting had caused metaplasia.
Rachel shared with group members that mouth breathing felt unnatural, and her body would try to continue breathing through her nose, even though it sent her into a fight-or-flight response because she couldn’t feel it properly.
She wondered if anyone else had experienced internal valve collapse and what their symptoms were. Her nasal breathing was noisy and difficult, and her automatic breathing had almost stopped. She felt pressure across the valve area of her nose and experienced a lot of accessory muscle pain, as well as difficulty sleeping at night without medication. She asked if fixing the valve could cause Empty Nose Syndrome (ENS).
Rachel sought advice on vitamin A nose drops or nasal spray available in the UK and asked if anyone had noticed physical improvement over time through measures such as sinus rinses and moisturizing the nasal passages, or if it was just a matter of learning to manage the symptoms mentally.
Rachel was desperate to find a way to retrain her body to breathe automatically. She manually breathed every breath unless she was asleep, which made her constantly dizzy and woozy because she couldn’t get the rhythm or depth right as her body would. She couldn’t concentrate on anything else.
Rachel's condition made her life unbearable. She asked for advice on how to deal with the fight-or-flight and panic symptoms, which made it difficult for her to eat, and she regularly gagged and even vomited if she didn’t work hard to keep her breathing under control. She took a beta blocker to try to manage her pounding heart.
Her breathing was completely disordered and under her control because she couldn’t sense the air going in and out of her nose. Her body wouldn’t let her sleep much at night because of this, and she often jerked awake covered in sweat.
Rachel’s symptoms had developed over a decade, starting with what she suspected was atrophic rhinitis, characterized by daily large patches of crust on her septum. She admitted, with embarrassment and regret, that she had picked off the crusts, leaving her nose sore and prone to bleeding.
In the last five months of her life, she began experiencing dizzy spells and waking up in the night feeling like she had been over-breathing and hyperventilating. This progressed to feeling suffocated during the day and night, unable to feel the air going into her nose, unable to take a satisfying breath, constantly manually breathing, lightheadedness, and panic. She was prescribed a corticosteroid spray by a doctor who thought she was congested, even though she felt the opposite, and this seemed to worsen her condition. She used saline spray daily, naseptin antibiotic cream, and coconut oil to moisturize her nose, but saw no improvement.
Rachel asked if it was possible for the nasal mucosa to "grow back" or if she was stuck with these debilitating symptoms. She prayed that her nose picking had not damaged her inferior turbinates irreparably.
Rachel Jordan’s story is a heartbreaking account of a woman who struggled immensely with a debilitating condition. Her efforts to find relief and her desperate pleas for help in the support group paint a picture of a life dominated by suffering and anxiety. Despite trying numerous treatments and seeking advice from others, Rachel’s condition continued to deteriorate, ultimately leading her to take her own life. Her story highlights the importance of having a functional nasal mucosa with mucus production and sensory ability.
About the surgery - septorhinoplasty
Rachel underwent septorhinoplasty, a surgical procedure that combines septoplasty and rhinoplasty. Here's a description of the surgery: Septorhinoplasty, is a procedure that addresses both functional and aesthetic concerns of the nose. It involves the following components:
**Septoplasty**
**Purpose** Corrects a deviated septum, which is the cartilage and bone that divide the nasal cavity into two nostrils. A deviated septum can cause breathing difficulties, nasal congestion, and recurrent sinus infections.
**Procedure**
- An incision is made inside the nostril to access the septum.
- The surgeon repositions, reshapes, or removes parts of the bone and cartilage to straighten the septum.
- The mucous membrane, a soft tissue lining the septum, is then repositioned back over the newly shaped septum.
**Rhinoplasty**
**Purpose**: Alters the shape and size of the nose for aesthetic reasons, such as improving appearance or proportion, or to correct deformities resulting from trauma or birth defects.
**Procedure**
- It can be performed either through an open approach (external incision at the base of the nose) or a closed approach (incisions inside the nostrils).
- The surgeon reshapes the bone and cartilage to achieve the desired appearance.
- Cartilage grafts might be used to reinforce and reshape the nose structure.
- The skin is then redraped over the newly shaped structure
**Risks and Complications**
- Infection, bleeding, or adverse reaction to anesthesia.
- Difficulty breathing through the nose if complications arise.
- Potential for scarring, numbness, or persistent swelling.
Atrophic rhinitis worsened after septorhinoplasty
In Rachel's case, the septorhinoplasty worsened her situation caused by Atrophic rhinitis and she experienced a debilitating condition known as Empty Nose Syndrome (ENS), where the nasal passages feel too open and dry, causing significant discomfort and breathing difficulties.
Most likely, a nasal valve surgery was performed during Rachel's rhinoplasty. This procedure involves the destruction of the nasal valves with spreader grafts in a so-called "nasal valve repair." This severely opens up the nose and causes ENS symptoms to an extreme degree, as the first gate to control airflow is destroyed.
We make an average of 15,000 inhales and 15,000 exhales through the nose every day. The nose is a high-traffic area, and exposing unprotected mucous surfaces to erosive airflows leads to rapid atrophy of the nasal cavities.
Think about it this way: the turbinates and internal nasal valves in the respiratory system are like heart valves in the circulatory system. The removal or destruction of heart valves will soon lead to a heart attack. Similarly, the destruction of nasal function (turbinates and nasal valves) sets off a destructive domino effect for all body systems that cannot be stopped.
Rachel’s suicide is one of about 50 suicides and 10 failed attempts we have registered in recent years following septoplasty, turbinate reduction, sinus surgery, or septorhinoplasty. These surgeries have one thing in common: they all destroy the nasal mucosa and the sensory ability to sense airflow. They all open up the nose and remove natural air resistance needed to inflate the lungs fully. Surgeons and society keep laughing while patient after patient gets their lives destroyed.
Below you find a word document with all the info we found about Rachel. It can be printed or downloaded at the right bottom corner of the embedded document.
