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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@donaldbernard

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

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I had it done in Boca Raton, FL at Dr. Nathan Nachlas' practice. Vivaer should who offers is as their equipment is used but its still new-ish so maybe a lot of ENTs are still learning about it. Dr. Nachlas is a surgeon as well and, some years earlier, talked me out of surgery as it would have been 'corrective' surgery with cartilage transplantation, etc. I was ready to consider as I got tired of trying to just breathe comfortably (through convoluted and semi-obstructed nasal passages) and made an appointment there only to find that the new radio-frequency technology could un-obstruct a lot of old scar tissue without any surgery. For me, it was an instant solution. I haven't slept with a Breathe Right during allergy season or anytime since. Years of using nasal sprays, steroid and non-steroid, did absolutely nothing for me as I had a structural problem.

By the way, Nachlas' practice doesn't 'specialize' in Vivaer. It's one of the tools they use where it makes sense. So maybe you'll find an ENT who Aldo added it to the practice.

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@nrd1

@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.

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Thank you. I'm flattered as I can tell from your posts that you too retain a, if not skeptical, at least appropriately critical approach to information on which medical decisions have to be made.

I've always joked that my desire about the medical establishment is to need it as little as possible and to never be eligible for participation in a class-action lawsuit against any doctor, hospital, pharmaceutical firm or medical equipment manufacturer because I was never harmed 🤔😏

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@donaldbernard

The problem is that the forum is anonymous and people say a lot of baloney on these forums.

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@donaldbernard, Mayo Clinic Connect is an online community for patients to share their experiences and to give and get support in their health journeys.

As per the disclaimer (https://connect.mayoclinic.org/blog/about-connect/tab/disclaimer/)
All information shared by members on the Mayo Clinic Connect, such as messages, images, advice, URLs, and any other material, is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on the community.

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@colleenyoung

@donaldbernard, Mayo Clinic Connect is an online community for patients to share their experiences and to give and get support in their health journeys.

As per the disclaimer (https://connect.mayoclinic.org/blog/about-connect/tab/disclaimer/)
All information shared by members on the Mayo Clinic Connect, such as messages, images, advice, URLs, and any other material, is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on the community.

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That is what I was saying, in a more pedestrian way.

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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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I have had nose problems for decades. It started when I moved to a cold city in the Midwest and after a year I had a lot of problems with dry feeling nose when I slept. One big issue was that my mucous changed. It went from slightly yellow and runny looking mucous to very sticky white milky looking mucous (no yellow whatsoever). I would as ENTs what this signified and they had absolutely no answer for me.

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@donaldbernard

The problem is that the forum is anonymous and people say a lot of baloney on these forums.

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Have you never contacted Vivaer directly? Surely, the owner/seller of the technology would know which medical practices use Vivaer as it is the lessor/seller. I will bet that Vivaer also knows of every single study done using its product
Thr company could answer all of your questions with one simple phone call. Granted,they are not likely to stress any negatives, but you could at least get a national list of providers.

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Aerin Medical contact information: 833-484-8237, aerinmedical.com, customerservice@aerinmedical.com.

They have a "Find A Doctor" search engine on their website @ https://aerinmedical.com/find-ent-doctor/
I used the search engine and saw 2 doctors on it because I found their info there.

I have contacted them through their website before, but did not get a reply.

I thank you for you suggestions, some of which I have already done, some not.

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Looks like the right place for me, Hi.
I am 71 years old, my ENT problem started with the 2nd Moderna shot in Feb 2021, which caused excessive mucus generation which has not gone away since. 6 months later, my ENT doctor put me on an extensive steroids and antibiotics course which made the matters worse. I also tested for allergies and hearing, had no apparent allergies and the hearing was fine too. In Jan 2022, the ENT physician performed a sinusitis balloon plasticity procedure on me which failed, imo. The doctor told me that he couldn't even enter my right sinus (the left didn't have much issue to begin with). I changed the doctors and had septum deviation and minor turbinate reduction performed about two months ago. It gave me a welcome partial dizziness relief but I still get dizzy (non spinning type) by midday, every day. I am scheduled for a ClariFix procedure in 10 days. I am expecting good results from it. However, if it fails then I will go for a VivAer procedure unless I learn that it can cause ENS syndrome, which would discourage me very much. If anyone has more information, please let me know, I will highly appreciate it, thanks.

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I don't know the answer to your exact question but have had the Vivaer procedure and it has been very effective. The reason for commenting is to kind of explain it. I've seen it referred to as an ablative protocol, meaning that tissue is removed, and that's not true from what my ENT described or what I experienced. [Though perhaps it can be used to actually remove tissue?] She explained that it 'remodels' tissue, that it can change the shape and size of an obstruction in my case. The radio-frequency essentially 'heats' an area which then responds by forming a kind of scar tissue, which is a contractive (shrinking) response. By and large, one is left with pretty much the same amount of tissue, but it has a different contour. Conceptually, I imagined a potter smoothing out a rough area to create a different curve or shape.

In my case, areas of the nasal passage that were too narrow, due to obstructing tissue, are no longer too narrow and it's easier to breathe. And I no longer take all the meds that never worked anyway because I didn’t have allergies or need steroids for non-existent inflammation. I didn't have a medical issue. I had a structural issue. The only alternative procedure to achieve a similar breathe-easy freedom would have required extensive reconstructive surgery, with cartilage transplantation and considerable risk. I have too little structural cartilage due to a sports injury years ago. Vivaer simply reshaped it.

Again this is only one person's experience but, for me, it worked immediately. That's not uncommon. According to my ENT, many patients breathe better the same day.

It didn't hurt though, as with dental anesthesia, the first injection of the numbing anesthesia, was pain-equivalent to a dentist's or oral surgeon's first injection.

There was no pain, no bleeding, no open-tissue healing, which was very important to me. I didn't want any broken tissue, or infection vector, yet alone during covid lockdown.

There was one area that was better but could be improved. The solution was a second appointment to 'touch up' that area. It took ten minutes. I get the impression, from that, that Vivaer can be done in stages if necessary and, because it is so subtle, an experienced practitioner is unlikely to overdo it as, because it can be touched-up so easily, there's no need to be overly aggressive in the first place. It's important to work with an ENT who has significant experience as it's a relatively new protocol. It was a perfect solution for my situation and ended years of inhalers, antihistamines, nasal sprays. None of which worked because they were solutions to a problem I didn't have.

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@callalloo

I don't know the answer to your exact question but have had the Vivaer procedure and it has been very effective. The reason for commenting is to kind of explain it. I've seen it referred to as an ablative protocol, meaning that tissue is removed, and that's not true from what my ENT described or what I experienced. [Though perhaps it can be used to actually remove tissue?] She explained that it 'remodels' tissue, that it can change the shape and size of an obstruction in my case. The radio-frequency essentially 'heats' an area which then responds by forming a kind of scar tissue, which is a contractive (shrinking) response. By and large, one is left with pretty much the same amount of tissue, but it has a different contour. Conceptually, I imagined a potter smoothing out a rough area to create a different curve or shape.

In my case, areas of the nasal passage that were too narrow, due to obstructing tissue, are no longer too narrow and it's easier to breathe. And I no longer take all the meds that never worked anyway because I didn’t have allergies or need steroids for non-existent inflammation. I didn't have a medical issue. I had a structural issue. The only alternative procedure to achieve a similar breathe-easy freedom would have required extensive reconstructive surgery, with cartilage transplantation and considerable risk. I have too little structural cartilage due to a sports injury years ago. Vivaer simply reshaped it.

Again this is only one person's experience but, for me, it worked immediately. That's not uncommon. According to my ENT, many patients breathe better the same day.

It didn't hurt though, as with dental anesthesia, the first injection of the numbing anesthesia, was pain-equivalent to a dentist's or oral surgeon's first injection.

There was no pain, no bleeding, no open-tissue healing, which was very important to me. I didn't want any broken tissue, or infection vector, yet alone during covid lockdown.

There was one area that was better but could be improved. The solution was a second appointment to 'touch up' that area. It took ten minutes. I get the impression, from that, that Vivaer can be done in stages if necessary and, because it is so subtle, an experienced practitioner is unlikely to overdo it as, because it can be touched-up so easily, there's no need to be overly aggressive in the first place. It's important to work with an ENT who has significant experience as it's a relatively new protocol. It was a perfect solution for my situation and ended years of inhalers, antihistamines, nasal sprays. None of which worked because they were solutions to a problem I didn't have.

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Thank you for describing your experience with VivAer, I found it very useful. I will sleep over it for a month or so, discuss it with my wife and the ENT specialist & go from there. Thanks again

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