monopolar cauter turbinate reduction
Doctor, on 2/8/08 (6 weeks ago) my doctor performed a bilateral mono needle point cautery turbinate reduction (4 passes each side submucosally), during my rhinoplasty he said they were hypotrified. He never explained this procedure to me prior to surgery evern when I asked twice and made it sound like it was part of the rhinoplasty. I never had any breathing problems up to the surgery. Now, 6 weeks later, my nose is still very dry (i use saline often and irrigate 1/2 times/day), my throat is very dry, I either stuffy/congested or air seems to flow to freely. I can sometimes feel a jet stream of air into my throat on the left side, my left ear is blocked, my left inside nose feels numb, my right feeling is a little better but not great, my sense of smell on the left is 50%and my sense of smell on the right is about 75%, and my breathing is shallow and quick. My doctor tells me everything is fine and he's never heard anyone complain about this procedure. Does this seem normal or am I experiencing ENS? Thank you.

7 week update
Doctor, Nose is less dry, but still irrigating and using saline. The current syptoms are to easy breathing, left side has some turbulence/noise when i hold the right nostril and breath normally. Left side has some feelings of blockage at times. There is a lack of proper airflow sensation on the left during normal breathing and this bothering me the most. I have had a CT Scan and when I looked, the front part of the left inferior turbinate looks smaller the the right side. I have read that with my procedure the turbinates can come back in size, and that this may resolve in 6 months from surgery. Will my body be able to adjust and normalize over time since I only had a cautery reduction and not a resection/turbinectomy. What do you think? I am seeing my surgeon next Thursday to review the CT scan, he already said it looks fine (but obviously I'm feeling uncomfortable). Thank you.

yes, you can very well recover fully a reduction rhinoplasty by definition will limit the nasal airway, so the turbinates (and septum if deviated) may be addressed to maintain a patent airway Your doc was not overly aggressive. When rhinoplasty docs cut out turbinates to maximize the airway, then that is a problem.

outfracture
Doctor, I forgot to metion I also had an outfracture done. Question is how do thesed bones heal/stablize after the outfracture or do they just hang down and move around when you breath? I can't find anything on line, except one idea was they tend to go back to a somewhat oringinaly state overtime. Thanks, Marc

They will heal in a firm position

CT scan
Hi Doctor, I reviewed the CT Scan with my Doctor. I showed him my concern on the left side inferior turbinate and he said this was due to lateralizing. He said everything looks normal. I have sent you a copy of the CT scan for your overall opinion of the inferior turbinates and whether you think it would be worth making a trip out to see you. Thank you.

CT Scan
Hello Doctor Houser, Have you had the chance to review my CT scan? I would like to consult with you on this after you have had the chance to discuss the symptoms I am still having especially on the left side. Thank you.

Your last name starts with "C" correct? I received it. As I recall it looked fairly normal although an odd tilt to the floor of your nose (not an ENS issue). I am away on a trip now, will look again when I get back.

Hi Doctor, I meant to ask you last week, how much turbinate tissue do you think was shrunk and what your thoughts were on the nasal floor tilt? Thank you.

the tilt is just a unique issue inherent in your anatomy and in no way pathologic. Think of it like a widow's peak, mole, etc. Your turbinates appeared of normal caliber. Perhaps a pre & post scan may detect a difference, but your turb volume looked essentially normal.

Hello Doctor, I’m at 4 months post op. I’m still experiencing symptoms of dryness, irritated throat/dry cough, pain inside nose on left side (off and on), and shortness of breath (due to diminished air pressurization). I have recently been to ENT (not my surgeon) and was told my inferior turbinate’s appeared healthy and normal in size (after an endoscopic camera exam). She couldn’t find anything anatomically wrong, just my complaints which she was hopeful would resolve over the next 2 to 8 months. The bi-lateral inferior turbinate reduction I had was done anteriorly. The CT scan shows larger openings anteriorly more so on the left side than the right which is in line with my degree of symptoms (left vs. right). I have read on other websites that with sub mucous cautery, the turbinate tissue can re-grow over 4-18 months. I read on this forum that there is not true re-growth of tissue; rather, the effects seem to wear off with time after “healing”. Effectively, would you agree that with the sub mucous cautery procedure the areas reduced could fill in/enlarge in time which would help with the symptoms and the lack of air pressurization? If the symptoms weren’t to resolve in 8 more months, would I be a candidate for injections vs. implants? I have included the link to my CT Scan. http://www.flickr.com/photos/26421748@N05/?saved=1 Thank you. Hoosemec

If symptoms persist at a year you may be a candidate for injection or implant - if your cotton test is positive. You might ask the doc there to inject your IT with saline (no lidocaine) and see if that helps temporarily, or do a cotton test.

Hi Doctor, What would be the risk of starting injections or implants at say 5 months rather than a year based on the procedure I had. The left side's pressurization is bad. I feel short of breath all the time causing axiety. Does the lack of pressure heal over time? This would be vs. another 7 months of torture and drugs for anxiety and sleep while waiting out the year. Thanks, Hoosemec

the problem may be that your nose will recover and if the turbinate were expanded in the interim then you would be too blocked up.

Hello Doctor, Thanks, again for your responses. I'm up in the Boston area, weather has been warm/hot and dry the last couple of weeks. Celtic's won in case you haven't heard. I'm a project manager for heavy construction and am exposed to ALOT of harse breathing enviroments. The big problem I have now is a burning sensation in my nose and throat when I breath. Currently I am on Gabapentin (Neurotin) for the pain and Lunesta for sleeping. Do you thinks either of these medications may have an adverse affect on this pain/dryness? Also, I plan on seeing the ENT up here again in about a week who thought the last time everything looked good (just to check on things, due to the magnitude of pain I'm in). Is there anything in particular you would look for to try and coincide with these symptoms, or is it possible to have this much pain with everything looking "good"? Thank you, Hoosemec