Vivaer nasal valve remodeling and Empty Nose Syndrome?

Posted by warpedtrekker @warpedtrekker, Nov 21, 2018

Has anyone had Vivaer procedure? I'm concerned about Empty Nose Syndrome but my doctor claims that only occurs with removing or shrinking turbinates. Doesn't the vivaer procedure also affect turbinates?

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@healthiswealth1

Hello group!

I have been expiriencing some very odd symptoms and will try to keep it condensed. In 2014 I had a turbinate reduction(no turbinates were completely removed thankfully) and a septoplasty due to my constant stuffyness and smothered feeling upon waking up. About two years go by and my stuffiness apears the same and also noticing that I feel much more winded when doing activities. Fast forward to july 2018 and I had my first ever anxiety/panic attack. When this occured I felt numbness in certain parts of my body which most of these symptoms are gone. The most notable symptoms that still carry on are these episodes of breathlessness upon simple exertion such as walking/moving fast paced, moving objects over 10 lbs, or pushing my laundry basket, going from low to high altitudes. Also speaking more then a minute causes a pressure breathlessness sensation near my pharynx.It is to the point where I had to leave my job due to the distressing feeling of passing out or running out of breath. I was cleared of any lung or asthma problems and heart apeared healthy from the tests and ct scans done.I am also relatively healthy and try to eat as clean as possible, bit have left out cardio due to my concerns. Ive seen 3 ent specialists and have cleared me of anything out of the ordinary.

What I am wondering is if by any chance a side effect from the turbinate surgery 4 years back could have altered any inhale signaling to the brain or nervous system. I know this could be over thinking but I have been expiriencing several symptoms related to ENS syndrome or empty nose syndrome which correlates to sensations of breathlessness, dry nose(as I have most of the time) and intermittent loss of sensation of air when inhaling through nose(usually when its too hot/humid or too cold). Again these symptoms all seemed to have come after my apparent anxiety attack and Still scratching my head in the sense if these symptoms are anxiety induced or complications of the surgery which I did not feel anything unsual until recent other than dryness and post nasal drip feeling since then.

Any suggestions or input would be
Greatly appreciated!

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Well I can relate most of your symptoms as I also suffered episodes of panic attack but I can say for sure that I was already experiencing the empty nose syndrome on one nostril after a terrible sneeze.I can’t speak for a full minute without stopping to get some air and I paused my life just to understand what exactly is happening.Since you posting from 2018 am hoping you have any updates as am really tired.

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@eboch9

I had the Vivaer Procedure done one year ago this month. I can now breathe perfectly and would recommend this procedure to everyone. I use to sleep in a pretzel position or sleeping almost upright in my recliner chair. I slept with my mouth open and snored before the procedure. The procedure took less that 1/2 hour and I immediately was able to breathe. There was a 2 week healing process which was slightly uncomfortable but nothing worse than before the procedure. The Avaer procedure has altered my life in making me able to function during the day and sleep peacefully during the night.

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Hi there I’m wondering what kind of symptoms you felt? My ENT wants me to have this procedure done but I’m afraid it won’t help. I feel like I can’t take a deep breath and often yawn to help. Did you experience any of that?

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@hollyhedge1-Hi. I know this question wasn’t asked directly to me. And I have not had this procedure. But perhaps I can help/shed some light, with a little more info.

•Why does this ENT “want” you to have this done?
•What diagnostic tests has this ENT performed?
•If this is just because you can’t take a deep breathe, what are your other issues?
•Is it your nasal airway that has been confirmed to not be getting air in or out?
•Do you sleep through the night?
•Have you had atleast 2-3 other opinions?
•Be very careful when someone else who’s had it done says that it has worked for them and it is great. That may be true. But with the upper respiratory system and anatomy being so unique, you have no way to tell why exactly this procedure was performed on another person.
In fact I think it is quite careless for anyone to ever recommend a procedure to everyone, based off of their own individual outcome. Bodies are too unique and programmed too differently.

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@eboch9

I had the Vivaer Procedure done one year ago this month. I can now breathe perfectly and would recommend this procedure to everyone. I use to sleep in a pretzel position or sleeping almost upright in my recliner chair. I slept with my mouth open and snored before the procedure. The procedure took less that 1/2 hour and I immediately was able to breathe. There was a 2 week healing process which was slightly uncomfortable but nothing worse than before the procedure. The Avaer procedure has altered my life in making me able to function during the day and sleep peacefully during the night.

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Can you tell us what was wrong with your nose at the time? Was there a diagnosis regarding the structure of your nose at the time? Was it specific to your turbinates?

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Doesn't the Vivaer procedure shrink the turbinate? I don't see how your doctor would say it does not shrink the turbinate. That seems to be exactly what the procedure does. It is an ablative surgery, it destroys tissue and shrinks it. The degree of shrinkage may be much less than other surgeries and that may be what the doctor was trying to say, so that the risk of ENS is greatly reduced compared to other more destructive procedures.

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Glad it altered your life for the better. When did you have the procedure and is it still working for you today?

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@donaldbernard

Doesn't the Vivaer procedure shrink the turbinate? I don't see how your doctor would say it does not shrink the turbinate. That seems to be exactly what the procedure does. It is an ablative surgery, it destroys tissue and shrinks it. The degree of shrinkage may be much less than other surgeries and that may be what the doctor was trying to say, so that the risk of ENS is greatly reduced compared to other more destructive procedures.

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Welcome, @donaldbernard. I see you have a few questions for the group. I'm tagging fellow members @nrd1 @warpedtrekker @healthiswealth1 @eboch9 @marychickadee @123d @chris77 @hollyhedge1 to make sure they see your questions.

Donald, are you considering the Vivaer procedure?

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@warpedtrekker

The only thing I know is the literature that my ENT doctor gave me. He said it is a non-invasive procedure that reshapes the nasal valve area, widening the area to possibly help with airflow. I've been to three different ENT's, and two of them wanted to go in invasively and fix my deviated septum, and reduce turbinates, either with coblation or other means. After hearing about ENS, I am not sure I want to take that chance. The Vivaer procedure apparently uses radio waves to shrink and reshape the nasal valve area. But then I saw a an article from an ENT doctor stating, that even messing around with the nasal valve area could cause issues like ENS. Because the nasal valve area is supposed to have some resistance of air.

I have "mild" sleep apnea(use BIPAP machine), had a DISE procedure which showed my tongue base collapsing blocking airway. I use BIPAP with dental appliance and still breathe through mouth sometimes and get obstructions. My ENT says he needs to start by opening nasal airway and then from there, consider other options for my tongue collapse and recessed jaw, like jaw surgery.

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I had the Vivaer procedure done and am extremely happy with it. The doctor I went to is an ENT surgeon and we decided that, to correct my breathing issues (worse during allergy season) would require a complex surgery with a possibly questionable outcome. Five years later he was offering the Vivaer radio-frequency remodeling (of cartilage) and thought it would be a solution for me. It was. I walked into the procedure breathing 'snuffily' and on pseudephedrine and walked out breathing better. Haven't taken any nasal decongestants since then.

It is not surgery, no anesthesia, no bleeding, no swelling. The local anesthesia, I think lidocaine, needles hurt. About as much as for an oral surgery for the first needle.

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Hey all. Been a rough couple of years. Had deviated septum/septioplasty back in 2020. Dr cut my turbinides pretty much off. after the surgery needed to go back to the office frequently due to being congested all the time, thick milky mucus. Kept blaming it on allergies. Allergy tested and got shots out of 5 my allergy rating is a 2. Fast forward a bit gave up on the first doc.
Went to see another one, tried treating it medically with antibiotics steroids, etc. sinus rinses daily with budesonide. 1 year later no improvement. Caught a cold in winter, stayed congested. Ct scan showed my Scilla no longer functioning. Went in for another procedure they drilled a hole from my nose to my maxillary sinus to promote drainage. Fast forward 2 months still congested. Comes and goes every two weeks. Latest they started me on dupixent shots every two weeks. Quality of life has diminished, becoming desperate to find a possible solution. Literally going through a box of Kleenexes daily of thick milky mucus

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@mel062284

Hey all. Been a rough couple of years. Had deviated septum/septioplasty back in 2020. Dr cut my turbinides pretty much off. after the surgery needed to go back to the office frequently due to being congested all the time, thick milky mucus. Kept blaming it on allergies. Allergy tested and got shots out of 5 my allergy rating is a 2. Fast forward a bit gave up on the first doc.
Went to see another one, tried treating it medically with antibiotics steroids, etc. sinus rinses daily with budesonide. 1 year later no improvement. Caught a cold in winter, stayed congested. Ct scan showed my Scilla no longer functioning. Went in for another procedure they drilled a hole from my nose to my maxillary sinus to promote drainage. Fast forward 2 months still congested. Comes and goes every two weeks. Latest they started me on dupixent shots every two weeks. Quality of life has diminished, becoming desperate to find a possible solution. Literally going through a box of Kleenexes daily of thick milky mucus

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Hello @mel062284, Welcome to Connect. I know how you feel as I've struggled with a stuffed up nose and congestion for years and found out I had a deviated septum when I had a sleep study done and was diagnosed with obstructive sleep apnea.

I thought the deviated septum was part of the problem and went to an ENT at Rochester Mayo Clinic to discuss getting a septoplasty. After listening to all of the pros and cons he recommended we start with a Mayo Clinic proprietary nasal spray – The 3 ingredients are Mometasone to reduce inflammation, Ipratropium to reduce nasal drainage and Diphenhydramine which is an antihistamine to help reduce nasal drainage. The product description on my prescription is MOMET 0.033% – IPRA 0.02% – DIPH 0.02%. I used it for about 3 months and it cleared up most of my congestion. I had to use a normal nasal rinse prior to using the nasal spray and did it in the mornings and evenings.

That was well over a year ago and rather than renew my nasal spray RX I decided to switch to a twice daily nasal rinse using the NeilMed Sinus Rinse Kit with Xylitol after reading an older study on Xylitol – Xylitol nasal irrigation in the management of chronic rhinosinusitis: a pilot study: https://pubmed.ncbi.nlm.nih.gov/21994147/

I'm not sure it will help you but it's a rather inexpensive thing to try so I thought I would mention it. Have you tried nasal rinses along with nasal sprays?

REPLY
@healthiswealth1

Hello group!

I have been expiriencing some very odd symptoms and will try to keep it condensed. In 2014 I had a turbinate reduction(no turbinates were completely removed thankfully) and a septoplasty due to my constant stuffyness and smothered feeling upon waking up. About two years go by and my stuffiness apears the same and also noticing that I feel much more winded when doing activities. Fast forward to july 2018 and I had my first ever anxiety/panic attack. When this occured I felt numbness in certain parts of my body which most of these symptoms are gone. The most notable symptoms that still carry on are these episodes of breathlessness upon simple exertion such as walking/moving fast paced, moving objects over 10 lbs, or pushing my laundry basket, going from low to high altitudes. Also speaking more then a minute causes a pressure breathlessness sensation near my pharynx.It is to the point where I had to leave my job due to the distressing feeling of passing out or running out of breath. I was cleared of any lung or asthma problems and heart apeared healthy from the tests and ct scans done.I am also relatively healthy and try to eat as clean as possible, bit have left out cardio due to my concerns. Ive seen 3 ent specialists and have cleared me of anything out of the ordinary.

What I am wondering is if by any chance a side effect from the turbinate surgery 4 years back could have altered any inhale signaling to the brain or nervous system. I know this could be over thinking but I have been expiriencing several symptoms related to ENS syndrome or empty nose syndrome which correlates to sensations of breathlessness, dry nose(as I have most of the time) and intermittent loss of sensation of air when inhaling through nose(usually when its too hot/humid or too cold). Again these symptoms all seemed to have come after my apparent anxiety attack and Still scratching my head in the sense if these symptoms are anxiety induced or complications of the surgery which I did not feel anything unsual until recent other than dryness and post nasal drip feeling since then.

Any suggestions or input would be
Greatly appreciated!

Jump to this post

how are you? did you find any answers or discover any resolutions or doctors that acknowledge your case?

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@warpedtrekker

I live in Austin Texas area. So any Mayo Clinic will be very far to go to. But I was planning to go to one of the Mayo locations due to other health issues that my current doctors can't figure out. The issue is no doctors in the Austin area work under one roof and talk to each other to figure out solutions for patients. There is no place except for mayo that does that.

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I live in this area too, it sucks for quality of care. I have been to Houston and John Hopkins and considered going to Ohio University as they will put that team together.
I have empty nose syndrome and it has affected my entire life like a domino effect. I may be able to offer support solutions and or more information that can lead you to more help, just be careful of ENT in our area.

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