Deviated Septum Surgery anyone?

[Bandi-T]

Before having turbinate reduction or turbinate removal, please consider one set of potential adverse side effects: Empty Nose Syndrome (google is handy)

An important working mode of the nose is the Nasal Cycle (google is handy again).

Speculation: What I gather from those two above is that congestion/swelling (and - my thinking again - maybe also turbinate enlargement) can often be a protective reaction of the body to the drying out of the mucous membranes in the nose caused by the unnaturally strong airflow caused by narrowed passages caused by a deviated septum. I would assume there is hope that if you fix the root cause (deviated septum) maybe the rest gets resolved by the body itself and you don't need turbinectomy/turbinate reduction.

My conservative view would be to err on the safe side, and elect not to do something (mostly) irreversible (turbinate removal) if there is still hope the body could return to health by itself if the root cause is corrected.

Disclaimer: I'm not a doctor, so not able to tell which particular cases have or don't have hope for the turbinates returning to normal. I just recently stumbled upon empty nose syndrome while doing research for my deviated septum surgery (as a first line of attack on my sleep apnea - that's how I got in this site), and wanted to warn others about the possibility of falling into that pit.

[Guest]

Hi....this is great timing...I scheduled my Septoplasty the same day you did! Perhaps we can go through this together and compare experiences. I was diagnosed with sleep apnea several years ago, but have been unable to tolerate the CPAP. The seal would break....I couldn't get it to stay in one place...and as soon as I would turn over, it would come off of my face. I got so frustrated....I just gave up.

I went to the ENT to discuss options. He discovered that my nose was so blocked it could definitely be contributing to the sleep apnea. The hope is once the surgery has helped....I will be able to wear a different style CPAP that I will be more comfortable with.

One nostril is 90% blocked...not sure about the other. I will also have the bi lateral turbinate reduction.

What date is your surgery?

[McSleepy]

There is an alternative I can suggest: viewtopic.php?f=1&t=59128&p=555825. I'm not claiming it would be better for you, but it is something to think about, given the graveness of septoplasty. I would definitely, though, caution about removing the turbinates - I doubt it one can live comfortably entirely without turbinates.

As for whether opening your nasal passages can help with your apnea - definitely, yes. While it is true that apnea is usually caused by collapsing of the soft tissue in your larynx (mostly the palate), it is also true that some people need to breathe through their nose and if that is obstructed, nothing will even get to the lungs. If you want to call it UARS, not apnea, that's fine, but it is a problem and would make your CPAP useless.

One other thing to watch for, and which goes along with the deviated septum, is bone spurs; and another thing that goes with diagnosed enlarged turbinates is excessive porous bony structure under the turbinates. The former has to be surgically removed (cut off), while the latter can simply be flattened using a procedure called "outfracture". The latter can be done during that non-invasive procedure I talk about in the above-referenced post. You should talk to your ENT about it.

One other note: the reason why doctors tell you not to use your CPAP after the surgery is not because your nose is blocked and it wouldn't work, but because the high pressure is bad for the traumatized tissue. So, full-face mask or not, it is considered bad using CPAP soon after the surgery. Having said that, I ignored the warning and used my CPAP the night after my procedure, in my bed, and it worked just fine; but then again, it wasn't septoplasty.

Good luck, whatever you decide to do!
McSleepy

[Kilgore Trout]

Before having turbinate reduction or turbinate removal, please consider one set of potential adverse side effects: Empty Nose Syndrome (google is handy).

Seconded! While most ENT's are very conscious of this, I had heard about it and asked my ENT if this was a risk. I won't quote her directly, but she explained Empty Nose Syndrome, how it can happen, and how this surgery is related--and set my mind at ease. I strongly recommend bringing it up, if for no other reason, so they can make you feel better, and more confident in what they're going to do.

Also: Bandi-T, please register!

[chunkyfrog]

If this is to be done, it should be with the best information and the best cutter possible.

[macewa]

i will see my doctor tomorrow and ask about this. But my understanding is that she is shaving the turbinates back and not total removal. But they cause me problems too because of my severe allergies that I am working on too. I figure things really can't get much worse than they are now.
Mary

Before having turbinate reduction or turbinate removal, please consider one set of potential adverse side effects: Empty Nose Syndrome (google is handy)

An important working mode of the nose is the Nasal Cycle (google is handy again).

Speculation: What I gather from those two above is that congestion/swelling (and - my thinking again - maybe also turbinate enlargement) can often be a protective reaction of the body to the drying out of the mucous membranes in the nose caused by the unnaturally strong airflow caused by narrowed passages caused by a deviated septum. I would assume there is hope that if you fix the root cause (deviated septum) maybe the rest gets resolved by the body itself and you don't need turbinectomy/turbinate reduction.

My conservative view would be to err on the safe side, and elect not to do something (mostly) irreversible (turbinate removal) if there is still hope the body could return to health by itself if the root cause is corrected.

Disclaimer: I'm not a doctor, so not able to tell which particular cases have or don't have hope for the turbinates returning to normal. I just recently stumbled upon empty nose syndrome while doing research for my deviated septum surgery (as a first line of attack on my sleep apnea - that's how I got in this site), and wanted to warn others about the possibility of falling into that pit.

[macewa]

My surgery is Tuesday, Jan. 31. For some surprising reason, I feel pretty calm about it.

I have had horrid problems with finding a mask and still it doesn't stay sealed because of my air pressure. I also have to put it on so tight that I end up with nose ache that turns into headaches and teeth ache because it pushes so hard against my teeth, and I always wonder if I am cutting off circulation.

Your blockage is worse than mine. One side 70% and other side 30%. So, half my breathing sapce is taken up. I would also get what I call nose burn higher up inside my nose and I figure it's from the air pressure trying to get through that small opening. Could be wrong, but if that was the only benefit, I would still be happy. But of course, I'm hoping for more.
==================================================

Hi....this is great timing...I scheduled my Septoplasty the same day you did! Perhaps we can go through this together and compare experiences. I was diagnosed with sleep apnea several years ago, but have been unable to tolerate the CPAP. The seal would break....I couldn't get it to stay in one place...and as soon as I would turn over, it would come off of my face. I got so frustrated....I just gave up.

I went to the ENT to discuss options. He discovered that my nose was so blocked it could definitely be contributing to the sleep apnea. The hope is once the surgery has helped....I will be able to wear a different style CPAP that I will be more comfortable with.

One nostril is 90% blocked...not sure about the other. I will also have the bi lateral turbinate reduction.

What date is your surgery?

[macewa]

Thank you for all the info and the good luck wishes. My thoughts were also that I have to be able to get air into my lungs for anything to happen. We will see. I will ask doctor to be more specific. My take was she wasn't going to do a total removal but make them smaller. Not sure and will ask tomorrow.
Thanks.

There is an alternative I can suggest: viewtopic.php?f=1&t=59128&p=555825. I'm not claiming it would be better for you, but it is something to think about, given the graveness of septoplasty. I would definitely, though, caution about removing the turbinates - I doubt it one can live comfortably entirely without turbinates.

As for whether opening your nasal passages can help with your apnea - definitely, yes. While it is true that apnea is usually caused by collapsing of the soft tissue in your larynx (mostly the palate), it is also true that some people need to breathe through their nose and if that is obstructed, nothing will even get to the lungs. If you want to call it UARS, not apnea, that's fine, but it is a problem and would make your CPAP useless.

One other thing to watch for, and which goes along with the deviated septum, is bone spurs; and another thing that goes with diagnosed enlarged turbinates is excessive porous bony structure under the turbinates. The former has to be surgically removed (cut off), while the latter can simply be flattened using a procedure called "outfracture". The latter can be done during that non-invasive procedure I talk about in the above-referenced post. You should talk to your ENT about it.

One other note: the reason why doctors tell you not to use your CPAP after the surgery is not because your nose is blocked and it wouldn't work, but because the high pressure is bad for the traumatized tissue. So, full-face mask or not, it is considered bad using CPAP soon after the surgery. Having said that, I ignored the warning and used my CPAP the night after my procedure, in my bed, and it worked just fine; but then again, it wasn't septoplasty.

Good luck, whatever you decide to do!
McSleepy

[macewa]

If you send me an email address, we can compare notes.

Hi....this is great timing...I scheduled my Septoplasty the same day you did! Perhaps we can go through this together and compare experiences. I was diagnosed with sleep apnea several years ago, but have been unable to tolerate the CPAP. The seal would break....I couldn't get it to stay in one place...and as soon as I would turn over, it would come off of my face. I got so frustrated....I just gave up.

I went to the ENT to discuss options. He discovered that my nose was so blocked it could definitely be contributing to the sleep apnea. The hope is once the surgery has helped....I will be able to wear a different style CPAP that I will be more comfortable with.

One nostril is 90% blocked...not sure about the other. I will also have the bi lateral turbinate reduction.

What date is your surgery?

[McSleepy]

So, how did it go?
McSleepy