What causes empty nose syndrome?

I have been reading on various websites where some people are questioning if allergies or sinusitis can lead to empty nose syndrome. The answer is a resounding no. Allergic rhinitis, sinusitis, postnasal drip, asthma, and acid reflux do not lead to empty nose. Only an aggressive turbinate surgery can. A CT scan and/or a thorough physical examination that details how much turbinate tissue is left, along with subjective patient reporting of symptoms, can provide a diagnosis of ENS. A cotton test, where a doctor places saline-moistened cotton in the nose, can also be used to determine whether it improves breathing or not, and consequently if the patient might have ENS. Unfortunately, there is such little understanding on empty nose syndrome that some people believe that a variety of conditions might cause empty nose - that's simply not true. This lack of knowledge and lack of readily available resources is part of the ambition for sharing my story.

The fact is only an overly aggressive nose surgery (of the turbinates) can lead to empty nose syndrome. Granted, a long-term sinus bacterial infection might lead to primary atrophic rhinitis but, given the increased antibiotic use and improved hygiene, this is rather rare in the Western World. What some people might be suffering from is in fact enlarged turbinates that are blocking breathing. Do I suffer from sinusitis and allergic rhinitis? Yes, I do, I have nasal and sinus inflammation, but this inflammation is not blocking breathing as it is with patients who have enlarged turbinates that largely block the airways. I have difficulties with breathing (among other nasal issues) because too much of the turbinates have been removed and my nasal airway is too wide open - a very hard concept for some doctors and patients to understand.

I believe that not all turbinate surgeries result in ENS. If they did, they would have ended long ago. But some do, and that's a point I hope every reader of this blog appreciates. And I further readily acknowledge a conservative turbinate surgery can be helpful, but I am a firm believer that all reasonable non-surgical treatments should be exhausted prior to undergoing surgery. It is just better practice to try to do everything possible before going under the knife. My experiences are proof of that.

Having Nasal Surgery? Don't You Become An Empty Nose Victim! describes what non-surgical treatment ideas are beneficial for treating the nose, which might prevent the need for surgery in the first place. Many treatment strategies for empty nose, although it is a distinct and different problem, apply to sinusitis, allergic rhinitis, and postnasal drip. It also critiques the medical literature on nose surgeries so that a patient can make an informed decision when and if they decide to pursue a turbinate surgery. I am not aware of any books that tackle the medical literature on turbinate surgeries and present the options in straightforward language, without vested interests of protecting surgery. Most books will just say if after you have tried various treatment strategies, then surgery might be a good option for you; here is how to prepare for it and what to expect. Conversely, Having Nasal Surgery? Don't You Become An Empty Nose Victim! details which turbinate surgeries are safer than other ones based upon the literature, which ones might leave you most at risk for empty nose, and what important questions to ask your doctor before surgery. This newfound knowledge might intimidate your doctor, but an informed patient is all the more power to you. Hopefully your doctor will appreciate that you want to take more of an active role in your health. Because you are the one who needs to take control of your health. No one else will do that for you.