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@seekinginfo (@nrd1)

Post Surgical Nasal Sinus Dysfunction/ENS

Ear, Nose & Throat (ENT) | Last Active: Sep 16, 2023 | Replies (28)

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I feel I have to add my voice to this issue. I was having sinus problems and “everyone” had an answer, including my GP. “You need washouts, you need to address your deviated septum, etc etc.” I also was lucky enough to be referred to a consultant who was extremely reluctant to intervene. I was initially a bit annoyed but, when I pushed for answers, he addressed the fact that surgery had limited potential benefit and a fair bit of risk. He even said that at times when patients say they feel better after surgical intervention, he was not entirely convinced. He said in my case he would intervene surgically only if the was so much blockage I couldn’t use the steroid sprays. And you know, even though I was being told he couldn’t do anything for me, except advise about non surgical approaches, I felt so much better and in control. And I really agree with @nrd1 that many of the “old” well intentioned surgical approaches were based on logic and engineering but with a complete lack of understanding of the complexity of the nose and sinuses. Hopefully they are learning.

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Replies to "I feel I have to add my voice to this issue. I was having sinus problems..."

@bride-thank you for adding in your comments. And it is great to hear that you had met with someone who was honest.
• The only way people or perspective surgical patients will get this information is by sharing it.

Many patients are unaware that when they get a referral or ask for a referral to an ENT that they are meeting with a surgeon. And that by the time you end up there, they are prepared for you to be ready to elect for a surgery.
•There is a code of silence in medicine. Especially in the ENT community, as the procedures that they offer make them a lot of money in a small amount of time. With little to know evidence that they actually work.
•Just to shed some light to help understand. Take a septoplasty for example. If you look at the “risks” that John provided from Mayo. Perhaps it would help to understand how a “hole” in the septum happens and how bad that can be. The skin is cut and lifted away from the septal cartilage. From there, the cartilage is shaved and cut in a chisel like way. The ENT has no way of telling if your cartilage is thick enough to withstand the chiseling and rocking back and forth of this cartilage, which is what shapes and holds your entire nasal cavity. If a hole is punctured through, which is very common, this is very hard to repair. Their are only a handful of doctors who are comfortable truly repairing this. So now you are left to find someone who can help with a new issue that you never had.
•I have spoken with a very reputable ENT at Stanford whom admits that half of the time, they do not even know how or why these procedures work. He also informed me that ENTs do not fully understand how the nose even works/functions. They are trained to “remove” things that look like they shouldn’t be there. They are not educated on the inflammatory/immune response, nor the cross over of the cranial nerve innervation to the neck and face. And the last thing their are equipt to assess is facial pain.
90% of the time the only doctors that should assess/address issues associated from the neck up should be a GP/Neurologist/Allergist/Dermatologis

This selection of doctors will help get to the root cause which is systemic and not driven by anatomy.

Much of this is genetic predisposition and how your body responds systemically. It has to be addressed from the inside.