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If you've ever had a sinus operation or are thinking about having one, you need to be aware of one of the most tragic of nasal problems, ENS.

ENS stands for Empty Nose Syndrome. This condition causes nasal problems in some people that can be devastating. The condition is tragic because it is doctor induced. That is, when nasal turbinates are extracted in whole or in part during sinus surgery, the condition can subsequently occur, sometimes taking 5 or 6 years to manifest itself.

Turbinates can swell and cause blockages in nasal cavities, leading to sinus infections. Thus, cutting out turbinate tissue during sinus surgery used to be a common practice. It is now better understood that these turbinates are part of a system that regulates the flow of air through the nose and into the lungs. The turbinates also filter air going into the lungs, and they add humidity such that the respiratory system does not dry out. Furthermore, turbinate tissue produces mucous and contains cilia, which are vital for the proper functioning of the nasal system. Cilia can be permanently damaged, and if that occurs the nasal system will simply break down, and you are bound to feel miserable

Dr. Eugene Kern of the Mayo Clinic in Rochester, Minnesota coined the term Empty Nose Syndrome in the 1990's after he and his colleagues observed that people who had turbinates or turbinate tissue removed during sinus surgery were still complaining about having stuffiness, sinusitis and other nasal problems, even though their nasal passages were very open, since their turbinates had been removed. These patients also experienced other symptoms, including shortness of breath, nasal dryness and caking, pain in the face, as well as depression and anxiety and a loss of the ability to concentrate. Dr. Kern studied the cases of over two hundred people with this condition and came up with the term 'Empty Nose Syndrome' now commonly referred to as ENS. Dr Kern even treated two people who were so miserable with this condition that they committed suicide! He has been counseling surgeons to be conservative in their surgeries, but since the concepts are still relatively new, not every ENT is convinced, and many will still extract turbinates and turbinate tissue. The bottom line is this: don't let your surgeon cut out your turbinates or their tissue if you are going to have sinus surgery. Another tragic aspect of the problem is that once the tissue is removed it cannot grow back, and techniques currently do not exist for successful transplants of other tissue.

One can learn more details about this condition by going to the web site of the ENS Association. Just do a search for 'empty nose syndrome' and you'll easily find the site. It features a forum in which people share their experiences, and just reading through some of the comments by people who are suffering from ENS nasal problems should be enough to make you extremely cautious if you are contemplating surgery.

One thing to keep in mind is that oftentimes people do not start experiencing ENS symptoms until 5 or 6 years after they have had surgery, as mentioned above. Essentially it can take that long for the remaining cilia left after the surgery to succumb to being overloaded and to fail. I personally had my second sinus surgery about six years ago, and I am watching out for ENS symptoms which fortunately are not an issue in my case thus far.

Anyone who has had sinus surgery or is contemplating it is strongly urged to go to the ENS web site. Scroll down the home page, and you will find a button where you can listen to Dr. Kern presenting a lecture to other surgeons. His talk is about a half hour in length, and it is particularly poignant when he describes the two patients he treated who committed suicide. It quickly becomes clear that this condition is a very serious one. You will learn a lot by listening to this tape and by studying the other information on the site. In fact anyone who suffers from sinusitis or other nasal problems should be aware of ENS in case they are ever confronted with sinus surgery.