söndag 18 augusti 2024

Empty Nose Syndrome Pathophysiology: A Systematic Review

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.


onsdag 17 juli 2024

Empty Nose Syndrome After Turbinate Reduction and Turbinectomy: Priscilla Robert’s Testimony

Empty Nose Syndrome · Video and patient testimony

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

The Video’s Commentary on Turbinate Reduction and Empty Nose Syndrome

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.

Priscilla Robert’s Testimony: Sinus Problems and Laser Treatment

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.

Turbinectomy and Septoplasty: The April Operation

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.

Emergency Care, Medical Consultations and Atrophic Rhinitis

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.

Life After Nasal Surgery: Dryness, Pain and Sleeplessness

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.

Remembering Priscilla Robert

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.

Priscilla Robert: Source and Supporting Document

Link to Priscilla's Testimony Syndromedunezvide.com

Bellow you find everything we found about Priscilla Robert. Print or download the document at the bottom right corner.

Open the document in a separate tab

söndag 23 juni 2024

Empty Nose Syndrome After Turbinate Reduction – Sherri Ann Cutrona’s Story

Sherri Ann Cutrona lived for many years with severe health problems following nasal surgery involving laser reduction of the inferior turbinates. Her experience provides a deeply personal account of the symptoms, medical consultations, treatments and complications she associated with Empty Nose Syndrome (ENS).

This page brings together her story, video material, medical experiences and information she shared with the Empty Nose Syndrome community. It is preserved to raise awareness of the potential long-term consequences that some patients report following turbinate reduction, turbinectomy and other forms of nasal surgery.

Video about Sherri Ann Cutrona's experience with Empty Nose Syndrome following turbinate surgery.

Sherri Ann Cutrona's Experience With Empty Nose Syndrome

Sherri Ann Cutrona lived in Manchester Township, New Jersey, USA. She was born around 1962–1963 and passed away on July 16, 2020, at the age of 57.

Originally from Hackensack, New Jersey, she had also lived in Brick before moving to Manchester Township. She worked as an engineer for Heyco Products in Toms River before retiring.

Sherri was active in the Tracheobronchomalacia (TBM) Support Group and the Empty Nose Syndrome Awareness community. Outside her health struggles, she enjoyed dancing, cooking, sewing and cruises.

Sherri Ann Cutrona, who described living with Empty Nose Syndrome after laser turbinate reduction
Sherri Ann Cutrona

Empty Nose Syndrome After Laser Turbinate Reduction

Sherri described a long and difficult medical journey involving symptoms she attributed to surgery on her inferior turbinates. She eventually came to understand her problems in the context of Empty Nose Syndrome (ENS), a condition reported by some patients after excessive alteration or loss of turbinate tissue.

According to information Sherri shared, the original procedure involved laser turbinate reduction. She later reported being told that approximately 50% of her inferior turbinate tissue had been reduced or removed.

Consultation With Dr. Oren Friedman

Sherri consulted Dr. Oren Friedman at Penn in Philadelphia. According to her account, he confirmed the diagnosis of Empty Nose Syndrome. She reported that treatment options offered at the time included Premarin cream, antibiotic ointment and nasal oil ordered from the Mayo Clinic.

Sherri left the consultation disappointed because she felt there were few treatment options available to address the severity of her symptoms.

Loss of Inferior Turbinate Tissue

During another consultation, this time by telephone with Dr. Das, Sherri reported being told that approximately 50% of her inferior turbinates had been removed or reduced.

She described Dr. Das as compassionate and knowledgeable about her complex medical situation, which she found particularly meaningful after years in which she often felt that her symptoms were poorly understood.

Severe Symptoms and Declining Health

In messages shared with other patients, Sherri repeatedly described the enormous impact her health problems had on everyday life. She wrote about severe dryness, chronic respiratory problems, sleep difficulties and the emotional burden of living with persistent symptoms.

At one stage she had a port installed to facilitate IVIG infusions because of problems with her veins. She described decades of declining health following the turbinate surgery and expressed how exhausting it was to live with multiple chronic symptoms.

One of the most striking descriptions concerned nasal dryness. Even after undergoing implant treatment, she continued to describe her nose as extremely dry — in her own words, "desert dry."

Severe Sleep Problems

Sherri also reported profound problems with sleep. In communication with another patient, she described the deterioration in sleep as beginning after her sinus surgeries and becoming a persistent part of her illness.

Sleep disturbance is one of the symptoms frequently described by patients with severe Empty Nose Syndrome, alongside abnormal breathing sensation, nasal dryness, air hunger and impaired quality of life.

Nasal Implants and Attempts to Treat Empty Nose Syndrome

Sherri continued looking for treatments that might improve her symptoms. She asked other ENS patients about their experiences with nasal implants, including patients treated by Dr. Jayakar Nayak.

She ultimately underwent an implant procedure intended to restore volume inside the nasal cavity following loss of turbinate tissue. According to Sherri, the implants were performed by Dr. Overdevst.

Approximately four months after the procedure, however, she reported that she had experienced no meaningful improvement.

She also investigated other possible approaches, including stem-cell treatment, and continued seeking additional medical opinions. A Computational Fluid Dynamics (CFD) analysis of her nasal airflow was also performed before the implant procedure.

Respiratory Disease and Other Medical Complications

Sherri had a complicated medical history that extended beyond Empty Nose Syndrome. She described years of chronic sinus and respiratory infections as well as severe asthma, GERD/reflux, IgG deficiency, sleep apnea, allergies and irritable bowel syndrome.

She later developed serious problems involving collapse of the trachea and main bronchus and underwent major surgery involving mesh support. According to her account, physicians considered several possible contributing factors, including chronic infections, occupational exposure to burning plastics, prolonged steroid use and her broader respiratory history.

Because several different medical conditions and exposures were present, it is important not to attribute all of these complications to Empty Nose Syndrome alone. Her history nevertheless illustrates how medically complex the lives of severely affected patients can become.

Nasal Function, Dryness and Respiratory Health

The nasal turbinates are not simply structures that obstruct airflow. They contribute to the normal conditioning of inspired air by helping regulate airflow and supporting warming, humidification and filtration within the nasal cavity.

Nasal mucosa also participates in the production of nitric oxide (NO), a molecule with several physiological functions in the respiratory system.

For patients who develop severe dryness or altered airflow following nasal surgery, these normal nasal functions are therefore relevant areas for further clinical and scientific investigation. However, Sherri's recurrent infections and later respiratory disease cannot be conclusively attributed to ENS from the information available here.

Living for Years With Undiagnosed Empty Nose Syndrome

One of the most important aspects of Sherri Ann Cutrona's story is how long she lived without understanding that her symptoms might be connected to the earlier turbinate surgery.

As the years passed, she described worsening symptoms and eventually learned that a substantial amount of turbinate tissue had been lost following the earlier laser procedure.

Her experience reflects a recurring problem reported within the ENS community: patients may experience paradoxical nasal obstruction, excessive openness, dryness, disturbed airflow sensation, air hunger and sleep problems even though the anatomical nasal airway appears unusually open.

Sherri Ann Cutrona's Final Years

Despite years of severe illness, Sherri continued searching for answers and treatments. She communicated with other patients, investigated surgical reconstruction, considered experimental approaches and sought additional specialist opinions.

Sherri Ann Cutrona passed away on July 16, 2020, at the age of 57. Available community accounts indicate that she was suffering from another serious lung infection around the time of her death, although this page does not independently establish the medical cause of death.

She is survived by her two sons, Cory J. Speiser and Shane C. Speiser, as well as other family members. Her final wish was reportedly to have her ashes scattered at sea.

Why Sherri Ann Cutrona's Story Matters

Sherri's experience illustrates the profound effect that severe chronic nasal and respiratory symptoms can have on quality of life. It also highlights the importance of preserving normal turbinate function whenever possible and of ensuring that patients considering nasal surgery receive balanced information about both expected benefits and potential complications.

Her story is especially relevant to discussions about Empty Nose Syndrome after turbinate reduction, laser turbinate surgery, turbinectomy, septoplasty and other nasal procedures.

Individual patient stories cannot by themselves establish medical causation. They can, however, identify important clinical questions, document patient experiences and help encourage further research into uncommon but potentially serious postoperative conditions such as Empty Nose Syndrome.

Key topics covered in Sherri's story:
  • Empty Nose Syndrome (ENS)
  • Laser turbinate reduction
  • Inferior turbinate tissue loss
  • Severe nasal dryness
  • Paradoxical nasal obstruction
  • Sleep disturbance after nasal surgery
  • Nasal implants for Empty Nose Syndrome
  • CFD nasal airflow analysis
  • Chronic respiratory symptoms
  • Long-term complications following turbinate surgery

Original Documentation and Additional Material

Below is the collection of material gathered about Sherri Ann Cutrona and her experience. The document can be viewed directly on this page. Depending on your device, additional controls may also allow you to open, print or download the document.

Important note: This article documents the experiences and statements attributed to Sherri Ann Cutrona and information collected from patient-community material. It is intended for educational and awareness purposes. Individual experiences do not establish that every medical problem described was caused by Empty Nose Syndrome or by turbinate surgery.

fredag 21 juni 2024

Empty Nose Syndrome After Septorhinoplasty: Rachel’s Story of Atrophic Rhinitis

 

The Story of Rachel Jordan: A Struggle for Every Breath

Rachel Jordan, a woman from the UK, tragically ended 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.

- Unsatisfactory aesthetic results requiring revision surgery.

- 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. 

onsdag 12 juni 2024

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


Introduction: Marcio Goulart, born on October 9, 1988, took his own life on April 21, 2020, at the age of 32 after a prolonged struggle with Empty Nose Syndrome (ENS). This condition developed following an almost total bilateral lower turbinectomy with septoplasty performed in 2018. The surgery, which removed 90% of his inferior turbinates on both sides, rendered his life unbearable and left him permanently disabled.


Before the surgery, Marcio was a successful English teacher in Brazil, living a happy and fulfilling life. However, post-surgery, he experienced daily sensations of suffocation, panic attacks, and could barely walk without feeling choked. He compared his breathing to constantly inhaling through tiny straws, with a perpetual sense of obstruction.









Despite the severity of his condition, Marcio's family did not take his illness seriously. He sought help from various doctors, including Dr. Piazza in Italy, who refused to operate on him due to the risk of further complications. This rejection deeply saddened Marcio, and he survived an initial suicide attempt shortly after.

Marcio was active on ENS forums, seeking support and exploring the possibility of getting implants from Dr. Das, though financial and travel constraints hindered his efforts. His condition and subsequent isolation led him to purchase a gun online. He shared his intentions with a few friends, hiding the weapon in his house. One night, after posting a farewell message on Facebook, he took his life.


The ENS community was shocked and heartbroken by Marcio's death. He was a beloved member of the forum, known for his kindness and openness. Marcio fought valiantly against a condition that made his daily existence a living hell, but in the end, he could no longer endure the pain and constant obstruction in his nose. His tragic story highlights the severe risks associated with turbinate surgery and the importance of taking ENS symptoms seriously.


July 16, 2020, A friend to Marcio gives testimony about Marcio's situation. “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"










Below you can watch an embedded Video of Marcio Goulart, victim of the new era Lobotomis "Turbinate reduction"  that leads to Empty nose syndrome: 

Direct link to the same video on Youtube.

Reviews Andre Luiz Gomes de Araujo
Marcios surgery was performed 
by the Brazilian surgeon 


Hospital UNIMED Vale do Aco
Rua Ipanema, 86
Centro - Coronel Fabriciano/MG
CEP: 35170-032
 
Below you can see 
the surgical report.

Surgical Procedures Performed

Right Frontal Sinus Surgery & Left Ethmoid Surgery
Procedure: Sinusectomy
Method: Videoendoscopy
Technique: Aspiration via Frontal Recess

Left Sphenoid Sinus Surgery
Procedure: Ethmoidectomy with Media

Turbinoplasty

Sinusectomy
Method: Videoendoscopy
Technique: Aspiration via Natural Ostium


in conclusion: The surgical procedures included a right frontal sinus surgery and a left ethmoid surgery, both involving a sinusectomy. This was performed using videoendoscopy, where a small camera was used to guide the surgery. In these procedures, aspiration was done via the frontal recess to remove fluid or tissue.

Additionally, a left sphenoid sinus surgery was performed, which included an ethmoidectomy and turbinoplasty. This involved removing parts of the ethmoid sinuses and reshaping the middle turbinate to improve airflow, also done with the aid of videoendoscopy.

Finally, a left frontal sinus surgery was conducted, involving another sinusectomy. The surgeon used videoendoscopy for guidance and performed aspiration via the natural ostium to clear the sinus.


When Andre Luiz Gomes de Araujo was done butchering Marcios nose his X-ray looked like this. Compleatly wide open, totally without inferior turbinates.

Andre Luiz Gomes Araujo now had created Empty Nose Syndrome. Marcio became yet another victim of the new era's lobotomy—namely, turbinate reduction.

This procedure leads to a condition that causes a constant feeling of suffocation. Many describe it as akin to constantly drowning without ever dying. Marcio was abused and subjected to mistreatment in the same way as thousands of people around the world who suffer similar fates. These doctors go free and, in many cases, laugh at the affected patients. Surgeons do not warn about the consequences of these operations because they are financially dependent on performing them. When patients return injured, the doctors try to manipulate them into believing they have psychological problems. When will these doctors be held accountable for the thousands of suicides worldwide their operations lead to?


Marcio's suicide is one of 46 suicides and 8 failed attempts we have registered after Turbinate reduction surgery in recent years. Below, you will find some selected comments from Marcio's YouTube channel and from Facebook groups where he was a member.

Comments from the ENS community to Marcio Goulart (You Tube videos and US forum)

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: http://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 th 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" 

Below you will find all the information we gathered about Marcio. The document can be downloaded or printed from the bottom right corner.