Empty Nose Syndrome

I regret having mentioned that I can empathize with the unfortuante victims of “Empty Nose Syndrome” when they can find no relief except suicide. Let me first assure you, so long as there is a shred of hope that I can some day find relief from, or at least some amelioration of this pain, I have no intention of committing suicide, because I have SO much to LIVE for.  Sadly, my mention of suicide has only served to distract you from my urgent question.  May we please start over?

I do not have a “perforated” septum.  I have a completely ABSENT septum.  The absense of the ability to humidify the air I breathe has resulted in extreme inflammation of the entire nasal and sinus region with concurrent excruciating headaches.

My question is,

Do you know of any procedure, including experimental techniques, to reconstruct a TOTALLY ABSENT septum so it can function as a scaffolding for transplanted mucous membrane tissue?

If so, is transplant of nasal mucosa a possibility?  Could an autograft of, for example, vaginal lining (in theory if not in reality) be attached to a cartilaginous scaffolding to substitute for nasal mucosa?

If, to your knowledge, there is no procedure to do exactly what I am seeking, could you give me some additional medical terms I may have missed so I can continue my research?  I have access to a medical school  library.

Thank you for holding this forum. MEJ

Answer

Hi,

I am very glad to hear you are not considering suicide. Still, THAT is my foremost concern and I still urge you to seek counselling sooner rather than later to make sure you do not let this issue overwhelm you.

Now as far as your nose, septal perforation is the term used to describe any hole in the septum, be it a small hole, a large hole or a complete destruction of the septum.  The only way to reconstruct a completely missing septum is with flaps.  Forhead flap or radial forearm free flaps as I mentioned in my last post.  Neither one supports mucosal grafts because there is no mucosa available in complete septal absence/perforation cases.  But the actual reconstruction of the septum does provide additional support and humidity to the internal nose.

Progesterone drops into the nose can result in hypertrophy and congestion of the lining which may be beneficial but this is experimental and not advised unless you can find an ENT who knows about this.  You need to work with a good Rhinologist.

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