Five Signs of Empty Nose Syndrome

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Persons with empty nose syndrome have a difficult time in getting a allowable diagnosis. Yet, correct prognosis and administration make a huge discrepancy in symptom relief.

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In a typical scenario, a outpatient presents to the doctor and explains she can't breathe straight through her nose. Then, the doctor looks in the nose and sees it is wide open. He doesn't see any blockage to breathing. He may portion the blood oxygen and sees that it is normal. If he orders a blood count, that is general too. He may resolve to "humor" the outpatient and give her a sample of a nasal spray. Then this outpatient leaves the office unhappy that she was essentially ignored.

The main sign of empty nose syndrome is the complaint of not getting sufficient air from the nose.

In Ens the turbinates have been removed or severely reduced. Instead of a blockage, the nose is de facto excessively wide open. But, like a garden hose, when the hose occasion is wide open, the water has very tiny pressure and comes out only inches. In the hose, when the occasion is made smaller, the water will scheme any feet.

Because the nose is now wide open, the sensors for air pressure don't get notified that there is air coming in. That much lowered air pressure "feels wrong" and so the outpatient feels like he isn't getting any air. Unless your doctor understands this, he will be confused.

The second sign of Ens is a history of nasal turbinate surgery. There are discrete procedures that doctors do to open a narrowed airway. These contain Laser Turbinectomy, Somnoplasty, Coblation, Microdebridement, and Turbinectomy. Despite care, sometimes too much nasal turbinate tissue is removed or destroyed.

A third sign of Ens is unusual pain. Because the airflow is severely changed, safe bet nerve endings may be stimulated. Because the pain is very difficult to pinpoint, the with anxiety is made much worse.

A fourth safe bet sign of Ens is frequent or constant nasal/sinus infection. There may be thick postnasal drainage and a constant sore throat. This is due to the absence of nasal cilia that are no longer there to move bacteria out of the nose, and to help moisten the air to the throat and lungs.

A fifth indicator that this is Ens is a reduced sense of smell and taste. The sense of smell is principal to life's pleasures. Sometimes the poor smell is the former complaint of the Ens patient. When smell sense is reduced, that also affects the sense of taste. You enjoy a steak because you can smell the cooked meat. The altered air currents don't bring the odor particles to the organ of smell in the roof of the nose, plus the immoderate dryness are both factors in causing the hyposmia.

Which comes first, the lack of sleep causing fatigue, or the fatigue from constant infection that causes poor sleep? Fatigue and uncut discount of potential of life can be significant.

For many Ens patients, a Ct Scan of the sinuses taken before turnbinate surgical operation may not even show sinus disease, yet for many Ens patients the Ct Scan taken a year later does show sinus disease!

Differential Diagnosis:
The doctor needs to make a differential prognosis here. Persisting sinus infection can also cause fatigue, poor sleep, and reduced sense of smell. The discrepancy is that in Persisting sinusitis, the airway is seen by the doctor to be swollen and partially obstructed.

Atrophic rhinitis is also called Ozena. Here there is severe nasal crusting, a bad smell from the nose, and the internal nose is wider. This health runs in families. There is a blockage of the blood provide to the nasal tissue, causing the basic bones, particularly the turbinates, to shrink. Gift mostly in females. The main discrepancy between Ozena and Ens is that with Ozena, you don't have a history of nasal surgery. Ozena shows much more foul smelling crusts.

Sjogren's Syndrome is characterized by dryness of the nose, mouth and eyes. It is an autoimmune disease that involves the glands that moisten the mouth and eyes, as well as the mucus secretions of the nose and throat. In Sjogren's, the former complaint is the dry mouth and eye, there is no history of nasal surgical operation and the nose shows ordinary turbinate tissue.

Therapy:
For Ens the former question is lack of nasal cilia and decreased mucus. It is this absence that allows bacteria to grow and perforate the nasal tissue and cause sinus disease. Therefore the best therapy is pulsatile irrigation because the pulsing saline going straight through the nose and sinuses, pulsaing at a rate analogous to the general pulse rate of the cilia, performs like regular cilia action. This pulsing operation with enhanced saline used early will preclude the principal sinus infections that often accompany Ens. Pulsatile irrigation for Ens also helps to massage the nasal tissue and bring more circulation to nasal tissue. If biofilm forms in Ens, pulsatile irrigation is an efficient means of removing these organized bacterial colonies. Later, if sinus disease has developed as a ensue of Ens, pulsatile irrigation is efficient in clearing the sinus disease. Of particular value is the fact that you can add your prescribed antibiotic to the pulsatile irrigation solution and avoid the systemic antibiotic effects.

For Atrophic Rhinitis pulsatile nasal/sinus irrigation has the advantage of being the best means of removing the thick heavy crusts. In orthopedics they reported that pulsatile irrigation is 100x more efficient for removing bacteria and crusts than simple wash.

In Ens, measures to heighten immune factors are important. Take iron if your hemoglobin is low, take Probiotic or yogurt to aid the production of immune factors. Cq 10 can be a help. Depending on what the doctor finds, he may ask you to use Premarin vaginal cream in the nose to build up membrane thickness.
Avoid cortisone nasal sprays as these will thin the nasal tissue. Ens patients are especially sensitive to saline spays that contain preservatives such as benzalkonium, so these should be avoided. Products like Atrovent or Afrin don't heighten Ens symptoms.

Anxiety is often seen in Ens, especially when the prognosis is not well established. I hope this presentation will justify many of the concerns of Ens patients and serve to sacrifice that anxiety.

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