"Inferior Turbinectomy is a nasal CRIME"
I would like to thank JR for finding this amazing book which was written recently by a well respected and known otolaryngologist: Functional Reconstructive Nasal Surgery (written by E. de Huizing). I am going to buy this book for sure and I highly recommend it to anyone who has ENS and wants to know more about nasal surgeries in general and specifically abut functional reconstructive nasal surgery. Besides the fact that the book ends with a chapter about functional reconstructive possibilities for atrophic rhinitis, which is meant just as much - for ENS, I found something most important: On page 278 the author gives an account of all the available methods for turbinate reduction. He begins with turbinectomy and writes a clear and damning accusation about it: "In our opinion, turbinectomy is a nasal crime. We feel that there is no reason (apart from malingnancies) to resect more than one-third to one-half of the inferior turbinate." Turbinectomy is a nasal crime - clear, decisive and to the point.

Where is this doc based?

Holland.

God Bless You! Fantastic research as always.

I wish I could some how afford to buy this book (it cost $151 before shipment which will be around $50 to Israel). If anyone has any connections with book stores, publishers, etc' and can help me get it for a cheaper price I'll be most grateful. Thanks.

TE, does it say where he is in Holland? My company is based there and I make frequent trips, though this year not until fall. Wonder if I could schedule some appointment not only for myself but as intro to this board and our cause. Probably a long shot but just a thought

this is a very interesting book at least the pages that are displayed. I see some references to his background. perhaps i can do some further research and find out where this doc is based.

I tried contacting Huizing. He used to be a Professor Emeritus of Otolaryngology at Utrecht University in Holland. In some of the pages of the book you can see that he performed implants using spongiotic/autogeneic bone into the septum and nasal floor to "narrow the nasal passage" as a treatment for atrophic rhinitis. Unfortunately, they told me he is now retired. I didn't ask for de Groot, but I believe it was Huizing who actually performed the operations. I stand to correction on any points though, and anyone is free to contact the university - +31 887 555 555.

Mark, That is a great idea. If you manage to track him down it could be very helpful to do the following: 1. Do a video interview of him to be presented on the ENS association website. We would like his opinion about inferior turbinectomies, middle turbinectomies and of course - empty nose syndrome. 2. Get all the information you can from him regarding his experience and knowledge with implant surgery for Ozena, Atrophic Rhinitis and ENS. This of course doesn't have to be on video. Unless you want to and he agrees. Recording it is enough though. If you do manage to arrange a meeting with him I would love you to contact me and together we will draft up the questions you need to ask him for the the video interview and for his knowledge on implant surgery. He belongs to a generation of ENT's who as young doctors still encountered quite a lot of cases of Ozena and AR, which today are very rare in western societies and this is why most ENTies have no experience with implant surgical repair for this. ENS today is wide spread :thanks" to radical turbinectomies that have become popular in the 80ties and 90ties, but because unlike Ozena or AR it is very difficult to diagnose - there haven't been many attempts with surgeries for this, and the knowledge from the generation of surgeons that had experience with surgical narrowing of the nasal cavity (until the 60ties) have basically died out or have been retired for many years and are old, therefore their knowledge has been to a great deal lost, as many of them did not do publish their results as they preferred to focus on their clinic more than also publishing articles. This is why interviewing people like Huizing can be really helpful as he may know things not published anywhere. Thanks. Very good initiative. PS I have to give credit here once again for JR for finding this book to begin with. Every-time I manage to locate another page on Google I am blown away by the stuff he writes.

I will see if I can make any contact with him and in the event I take a trip there in the fall, I'll see if I could arrange something. Holland is not a large country, so with a little luck maybe it would work out. Yes, I would be happy to have you draft up questions so we could maximize any available time that he would offer to us.

Let me know when you have a date set and we'll draft something up. Could you also make a video of him (if he agrees of course)?

Sure, I would make arrangements to bring a video camera

Great, thanks. Looking forward to it.

I recently received Professor Huizing's book and I wanted to share with you his definition of ENS. It's a little lacking but nonetheless the most elaborated explanation I have ever found in the medical literature (except for Dr Houser's implant series article from 2007): EH Huizing, J AM de Groot. Functional Reconstructive Nasal Surgery. Published by Thieme. 2003. Pages 64-65: Wide Nasal Cavity Syndrome ("Empty Nose" Syndrome): The wide nasal cavity syndrome may occur when too much of the inferior and/or middle turbinate has been resected. Stenquist and Kern (1996) have recently drawn attention to the characteristic symptoms and findings of the iatrogenically induced wide nasal cavity. They introduced the term "empty nose syndrome". The wide nasal cavity secondary to endonasal surgery has become more and more common in recent years, as (sub)total turbinectomy has again become popular. Patients with a secondary wide nasal cavity may suffer from a variety of complaints: for instance, a feeling of nasal obstruction in spite of normal breathing; nasal irritation and itching; headaches and pressure feelings; radiating pain on inspiring cold air; crusting; and minor blood loss. The severity of these complaints differs considerably from person to person. Some patients have only minor symptoms, whereas others are real "nasal cripples". On examination, the nasal cavity is abnormally spacious, lacking (part of) one or both turbinates. Mucosal pathology varies greatly. In some patients, the mucosa is dry and pale because of metaplasia; in others, it is red because of chronic infection. Crusting may range from absent to severe. The symptoms and findings are believed to be caused by abnormal air currents due to the disturbed anatomy. In many cases, however, the discrepancy between the degree of the anatomical disturbance and the severity of the symptoms is difficult to understand.

Re: "Inferior Turbinectomy is a nasal CRIME"
Turbinectomy is a nasal crime - clear, decisive and to the point. We feel that there is no reason (apart from malingnancies) to resect more than one-third to one-half of the inferior turbinate." i have only 25% IT resected each side but have a lot of insane symptoms including inability to feel air and emptiness, including facial tension, facial pain, nose tension, strange pressure and etc.etc.etc.etc.. i don't mention social avoidance. before surgery i have never had it. isn't it a crime? :(