Vivaer nasal valve remodeling and Empty Nose Syndrome?

@emptynose
I am so sorry to hear this.
And it helps that you share it so that more people are aware.

These situations happen weekly in the ENT setting. It is both tragic and disgusting how common these types of stories are. Neurologists know this as well.

I understand the exposure to the nerves you are dealing with and I hope you have found some way to cope/relieve the pain.

I had the Vivaer procedure in 2020 to remodel cartilage that made nasal passages too narrow and restricted breathing during allergy season. It worked great for me from the first day and spared me complicated surgery. I saw the ENT who did the Vivaer last week for an annual follow-up and asked her if the Vivaer can help someone with Empty Nose Syndrome and she said that she would not perform Vivaer for that as ENS is very complicated and is frequently unfixable as it can result from a surgery gone wrong, leaving too little tissue, cartilage or bone to work with.

She's been doing the Vivaer procedure since it was first approved and has done over 500 of them by now. It's is non-ablative (no tissue is removed), non-surgical and painless and great for situations where it can help. But I'd get a second opinion on anything unusual and make sure the ENT has a lot of experience with the Vivaer.

@callalloo
Thank you for sharing your experience and these details.

Hopefully this can bring more awareness for others to know they have options-non surgical in their approach.

ENTs themselves are speaking out against the misuse/misrepresentation of many of their surgical methods.
When their own colleagues begin to warn against their surgical approaches, it’s just a matter of time before you start hearing and finding more ENTs whom are interested in offering in office procedures vs. OR surgeries.

And as you said-get a second opinion. I would even recommend 3 opinions in an ENT community.

One from a solo practice, a smaller group practice and a large institution. Watch how different the feedback/opinions will be.

@mel062284
I am sorry you are experiencing this and I know you are frustrated.

Do know that your experience is not rare. These are just not shared or reported. What you are going through is very common. Along with the direction you’ve been given post surgery.
Allergy shots, when you would have never needed them before. Nasal Rinses w/ antibiotics that you most likely never had needed before.

This becomes a physiological issue vs. a pathological issue.

What the ENTs are recommending for you now, are the only thing they have to offer once the function has been disrupted due to surgery.

These side effects can happen just from a septoplasty alone. But is more likely to occur when any other tissue/bone such as turbinates are altered/removed.

Have you been to one of the few major tertiary institutions that are willing to explain this-such as Stanford?

I have been very open here about my opinion on nasal/sinus surgeries. I get many responses of people who refuse to believe that so much harm can happen. But it does and most people don’t hear about it.

You could try one of the few tertiary clinics whom acknowledges these issues- Stanford.

Again-thank you for sharing in order to bring awareness.

I'm currently in the journey. ENS causes a negative domino effect through out the body.
Majority cannot work any longer and financial stability is threatened. Healthcare is not set up to understand or treat leaving hundreds, that I know of, desperate for solutions, understanding and help. We are taken advantage of from treatments that do not work or make it worse,as we enter a world of despair, many take their own life in agony and loss of hope. Every single day is a nightmare you don't get to wake up from. Sinus should never be touched. Turbinates and structures of the cavity are there for a purpose. Yes, you are right they know the assault on the body this creates. Unfortunately ignorance, malpractice and human unawareness remains in an industry based on money and unnecessary surgery instead of taking time to care for the patient and investigate the cause and effect.
Thank you for your interest.
I haven't all I can do is live in the hour by hour.

@emptynose
Thank you for your detailed and honest response. I know it’s not easy to post, but hopefully it will resonate with others when they are looking for information.

I would recommend anyone whom is entertaining the idea of an elective (non life threatening/emergency) surgery, to take the time to comb through online videos of ENTs speaking to other ENTs on their campuses, rhinological meetings and panel discussions. After watching/ listening and seeing how indifferent they all are- Their surgical failures and reasonings for those failures and how much they do not truly know about the nasal function, fairly certain people would be able to make a more informed decision.

-there is even one panel discussion w/ an ENT whom claims he no longer does turbinate surgery due to being involved in too many litigations. Doubt he would ever tell a patient that’s his reasoning.

So just be very educated and aware everyone.

I learned one thing when interviewing surgeons about nose surgery (until the best one explained how really complicated it would be and talked me out of it). The nose and breathing system is seriously complicated. I researched a lot, read studies, and paid very close attention to abysmally-failed nose surgery disasters. But I had no appreciation of all that the nasal passages and nose have to do. The obvious jobs include warming and "dampening" too-dry air. Nasal hairs trap pollutants including bacteria and viruses. And there's an area in the back region that makes antibodies to help kill some of the germs stuff. When covid hit, I used an inexpensive NeilMed nasal lavage daily with the NeilMed salt/baking soda solution after reading that the covid virus was killed by salt in some article. And the covid virus was known to hibernate at the back of the nose/throat so I figured it was worth a try.

I'm a sailor and was interested to read how, in a sense, the nose also balances differential airflow, in part to protect the ear canals. Not the same as trimming sails but the aerodynamics are similar as balancing different forces is what makes it all work.

The ENT who talked me out of surgery and, years later, did the successful Vivaer, was happy to talk with a patient who was impressed with how complicated the while ENT system is and why he still finds it fascinating.

Does anyone know of an experienced Vivaer doctor in New York who can assess my nose situation? Also, does anyone know of any recent studies on Vivaer, there does not seem to be any available except for those done by doctors who were paid by Vivaer? I have been to a few ENT doctors and they are very limited in explaining what may be going on in my nasal valve area.

Did you get your Vivaer procedure in the New York area? I have not been able to find a ENT that specializes in Vivaer.

@callalloo
This is probably one of the more educated posts I’ve read.
Great job on your part for self educating. Very few patients and people in general that take the time to do this.

I like how you used the word “interviewing”. This is the mind set that more people should have when seeing a surgeon. After all, they provide a service that you are paying for, that involves your body. It also sounds like you had been seeing a responsible ENT, who provides more education than just trying to sell you on invasive surgeries that are un proven.

Great to hear you eventually came to an approach that was successful for you.