@denisec526- you’re very welcome and your detailed reply & information is very helpful. You sound very knowledgeable of your own body which is good, so you can be your own advocate.
-With the additional information you provided I can share with you what I have learned from ENTs themselves and other medical professionals.

-If you experienced hypersensitivity in this area as a child, as you explained in the cold weather in which you noticed it and can remember, then it sounds like this area for you was prone to sensitivity, congestion from the elements and activation from your nervous system. Perhaps a more thin mucosal lining.

-QUESTION-do you have any other body sensitivity issues? Tight neck or shoulders?

-We all start out with a mucosal lining throughout the body. The same lining in your nose, runs through your throat, gi tract, gut etc...Some people suffer gi upset, while some people suffer nasal issues. It’s all the same nervous system function. Stress can activate in different ways in different areas of the body. This is what sets of “disease” or “itis”. Cold temperature is a stress response to the body. Some people’s scalps tighten when they feel cold. Other people’s noses constrict more than others. It’s all an example of “stress response”

-It is very important to care for lining inside of the nose as it is prone to dryness from so many things and overtime it gets a little more dry as we age.

-Unfortunately nasal steroid sprays, antihistamines, and many OTC medications we reach for out of desperation have so many drying affects and they do not warn people of these affects over time. They are just trying to stop the issue in the present moment.
It’s a band aid for a systemic issue and naturally that bandaid is going to wear off.

-ENTs are very behind in understanding the why’s and how’s of the nasal function itself. They leave out the major systemic/internal component and treat every patient the same. Most patients would never need an antibiotic for a sinus inflammation issue. Most are viral. And people prone to congestion tend to get viral infections more often. If not diagnosed correctly from the beginning, this can actually set the patient up for more harm down the road.

-ENTs are very unhelpful with describing the objective of pain. They will only look for an objective cause for the pain. Being a blockage or infection/inflammation.
QUESTION: If you have been to an ENT and they’ve told you they don’t see any structural abnormalities (which is a good thing) then I’m sure they have then told you it is inflammation?

-The nasal mucosa is extremely delicate and not like any other skin externally. It is epithelial tissue, meant to expand and contract. It follows a very fine and unique system to expand and contract throughout the day. This system also expands contracts during “concentration” “reading” and “fight or flight”.

-If over time this tissue has atrophied you might not be experiencing the congestion that you had been used to. Causing you to feel the emptiness sensation.
If on your right side the mucosa is not sensing the air appropriately, it is also not moisturizing or humidifying
If you have less nasal secretions on the right side, this can cause you to feel a burning sensation as well.

A few recommendations to add as options:
-I would recommend scheduling a phone consult with Dr. Das as he could explain this better and ask better questions from a medical professional. He possibly has helped non surgical patients with this issue.

-There is a reflex arc that travels along the trigeminal nucleus when the nerve is irritated in the nose. This reflex arc can cause migraine symptoms or vice versa.
Many people diagnosed with migraine only get symptoms in the nose. So it is worth describing this entire feeling to a Neuro.

-Work with a Somatic body therapist to help with the pain response. Pain brings anxiety and anxiety brings pain. The nerves will be more activated in the nose when the nervous system is stressed.

-Research Ayurvedic ways you bring healing back to the nasal mucosa.

-With much of your antibiotic and OTC pain med use. Try to restore your gut lining as much as possible. Disruption to the gut lowers the stress/anxiety pain tolerance response. (This is a while other area of gut-brain axis, which I won’t go into) But it ALL matters.

I hope my additional points can help you.