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Empty nose syndrome


It is possible to feel breathing again. Stem cell transplantation for a life without anxiety.

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Improvement of breathing due to cell therapy


  • What is empty nose syndrome?

    The term "empty nose syndrome" (ENS) was first introduced by scientists E. Kern and M. Stenkvist in 1994. That's how they called the condition in some patients after conchotomy — a minor operation resulting from which a part of the nasal cavity is removed.
    In 2001, in their publication, E. Moore and E. Kern indicated that the causes of secondary atrophic rhinitis and empty nose syndrome include complete (22% of cases) or partial removal (56%) of the middle and lower nasal sinuses. Such operations are traditionally performed in the following cases:
    chronic rhinitis; sinusitis; nasal polyps; injuries after which the mucous membrane of the nasal sinuses grows;connective tissue scarring with impaired nasal breathing.

  • Empty nose syndrome symptoms

    ENS is a condition that develops after surgery in the area of ​​the nasal sinuses. Herewith physiologically necessary functions of a nose are broken:
    humidification and heating of air;retention of microparticles during inhalation; a full sense of taste and smell; transmission of nerve signals of breathing to the brain.
    The most common complaint of patients with ENS is related to the last point.
    "The illusion of nose absence", "discomfort that is almost impossible to live with", "suffocation from which is no escape" — are the frequent descriptions of pathology given by people who have experienced it.
    Such people almost always have sleep problems, constant anxiety, and, as a result, nervous system overload, autonomic dysfunction, and cerebrasteic syndrome.Besides, patients often experience the following symptoms:
    dryness of the nasal mucosa; crust formation; nosebleeds; swelling and pain in the nose; headache and dizziness; decreased sensitivity of smell and taste; chronic fatigue; mood swings and irritability.

  • ENS causes

    The exact reasons for the disease remain to be unclear. The most probable cause of the disease is a violation of the air's physiological turbulence in the nose and decreased mucosa area. The last one is involved in heating and humidifying the air. Thus, complete removal of the lower nasal sinuses can reduce heating and humidification by about 23% (Amarbir S. Gill et al., 2019). As a result, the sensitive innervation of the nose is disturbed.ENS is not the only serious complication after conchotomy. According to some data, the risk of atrophic rhinitis after this operation reaches 22%.
    Because the symptoms are subjective and often difficult to describe, and the exact causes of the disease are not known for sure, there is still debate about the diagnosis of ENS.Good Cells Clinic is completely ENS-friendly.

  • Why doesn't everyone have ENS and atrophic rhinitis after conchotomy?

    It is not already possible to answer this question precisely. However, it has been shown that the likelihood of ENS or atrophic rhinitis increases with chronic rhinosinusitis or dry anterior rhinitis.

  • ENS treatment

    This condition significantly reduces the quality of life. But, the methods of traditional medicine are still mostly symptomatic. Patients are usually advised to wash the nose, do inhalations, and use moisturizers to deal with dryness. Psychotherapy and medication are recommended to improve the mental state. In severe cases, perform surgical reconstruction of the nasal passages to restore physiological airflow.
    None of these methods is able to restore the nerve endings and the mucous membrane of the nose. We are sure that only under such conditions it's possible to return to normal breathing.

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ENS treatment in Good Cells

We offer treatment of ENS with the use of biotechnological materials and multipotent stem cells.
The programs of therapy are selected individually for each case. Defects of the nasal sinuses and the patient's health are necessarily taken into account.
Our methods:
1. Intranasal injection of cells derived from the neural crest.This method improves the nourishment of the nasal mucosa and stimulates the restoration of normal receptor function. This approach reduces the intensity of symptoms of ENS, including psychological.2. Autologous fat transplantation.3. Transplantation of autologous and allogeneic drafts with biotechnological materials: ADSCs + Acell, UC-MSCs + autologous fat products, HF NCSCs + autologous fat products + exosomal products, and others.
The last two methods help to restore the physiological aerodynamics in the nasal passages and harmonize breathing.
You are not alone with your problem. There is a chance for improvement!


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Why cell therapy?

None of the standard treatments for the syndrome is able to restore nerve endings and nasal mucosa. And we are convinced that only under such conditions it's possible to normalize respiration.

We offer treatment of ENS with the use of biotechnological materials and multipotent stem cells.

For whom is this method suitable?Therapy may be suitable for patients over the age of 18 with a diagnosis of empty nose syndrome who want to try alternative treatments.
Treatment programs are selected individually for each case. Defects of the nasal sinuses and the patient's health are necessarily taken into account.
Contraindications to cell therapy:oncological diseases or their presence in the anamnesis for the last five years; pregnancy;psychiatric disorders;alcohol and drug addiction.


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Cell therapy for ENS treatment

It is necessary to approach the treatment of ENS comprehensively. It is often necessary to restore not only the functionality of tissues but also their volume. Reducing the load on the nervous system is an essential part of therapy as well.

Function improvements

For ENS treatment, we use intranasal administration of multipotent stem cells derived from the neural crest.
This procedure improves the function of epithelial cells and reduces inflammatory reactions. Due to this, the damaged mucous membrane of the nasal sinuses is restored.

Partial restoration of morphology

In cases where the connective tissue and the morphology of the damaged tissues are severely damaged, we use additional approaches:

1. Intranasal injection of adipose mesenchymal stem cells.
It has an anti-inflammatory effect and improves the structure of nasal tissues.

2. Use of biotechnological implants.
They can be of different origin: autologous fat, bone crumbs, or bone chips. In some cases, these materials are supplemented with synthetic components.
This therapy is able to compensate for the volume of nasal tissues, reduce inflammation and swelling, improve the functioning of the mucous membrane and increase its sensitivity.


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The treatment process

1

Consultation with a manager

Contact our managers with no obligations on your side. At this step, we gather your medical information and confirm the diagnosis. After that, we'll arrange a free online or offline consultation with a doctor.

2

Online/offline consultation with a doctor 

A personal consultation with a doctor is an excellent opportunity for you to find out all details of the program and get an individual prognosis. All the medical information you provide will be carefully reviewed so that you get the most effective treatment. The procedures take place in our clinical institutions in Kyiv, Ukraine. The course of the treatment is developed individually and lasts 4 days or more.

3

Checkup

During the checkup, the doctor assesses your readiness for cell therapy. If the assessment is positive, biological materials are taken. Depending on your doctor's recommendations, you may be prescribed your own* or donor stem cells.
*If you are prescribed the treatment with your own cells, you will have an ear punch biopsy performed under anesthesia in an operating room. The procedure lasts for 15 minutes. The punch depth is up to 4 mm, and the diameter is up to 3 mm.

4

Preparation of the stem cell product

OWN CELLSAfter the biomaterials are collected, our team of biotechnologists will prepare a therapeutic dose of stem cells. In our laboratory, we will select stem cells from your sample, grow the required number of cells, test them, then create a stem cell product for your treatment. Usually, the production takes up to 21 days.
DONOR CELLSAccording to the doctor's prescription, the biotechnologist will select a ready-made and pre-tested sample of donor cells from our cryobank in the required quantity. In this case, cell injection can happen immediately after diagnosis and drug preparation.

5

Start of treatment

During your first visit to the clinic, you will consult with a doctor, then have an instrumental (including electromyography), clinical, and laboratory checkup.

6

Injection of the cellular product, the regeneration phase

As part of treatment, the doctor may prescribe local and intranasal administration of the cell drug. Both procedures can be performed 1-2 times per visit.

7

Medical assessment report and weakening of the basic treatment 

You will be provided with a medical assessment report that states the diagnosis, the examination results (clinical, laboratory, and instrumental), the treatment process, and further recommendations. The doctor will examine you, select the necessary treatment, or adjust the one prescribed to you at the time of arrival at the clinic.

8

Keeping in touch

The main results can be observed within 6 months after treatment. You will see the improvement of the regenerative processes in the body.
Throughout the program, you will have a personal manager who will ensure the best communication between you and the clinic. After treatment, our patients are advised to maintain contact with us. We'll ask you to fill out a questionnaire in 3 and 6 months after the treatment to evaluate the progress and answer all questions.

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Scientific evidence

The primary purpose of the stem cells and tissue-engineered constructs usage in empty nose syndrome treatment is to reconstruct the lost areas of the turbinate and mucous membrane, which will restore normal physiological air circulation through the nasal passages, and eliminate symptoms.
Studies by Xu X. et al. (2015) showed that the reconstruction of the nasal mucosa's function by angioplasty in combination with transplantation of adipose tissue MSCs and particles of autologous adipose tissue significantly improved symptoms in patients with ENS. Details in the original publication https://doi.org/10.1186/s13578-015-0045-7.
Another study conducted by Saafan M. (2012) showed the same effectiveness of submucosal transplantation of cell-free alloderm and silastic membrane in ENS patients. Subjective evaluation was performed by checking the SinoNasal test results (SNOT-25), while objective evaluation was performed using anterior rhinoscopy and nasal endoscopy. There was a significant improvement in both groups of patients after graft transplantation (mean SNOT-25 score before implantation was 61.4 compared to 33.6 after implantation of silastic material, while in the alloderm implantation group, it was 63.7 vs. 34.2 after implantation). The objective evaluation showed rapid healing without signs of implant infection, rejection, or allergies in either group. Details in the original publication https://link.springer.com/article/10.1007/s00405-012-1955-1.
The acellular dermal matrix combined with hyaluronic acid can be an excellent alternative to grafts from its own adipose tissue. Unlike the latter, it does not lose its volume and is not resorbed after transplantation. Details in the original publication https://link.springer.com/article/10.1007/s00266-020-01680-8.
Combining the soluble fraction of the extracellular matrix of adipose tissue and methylcellulose is another promising biomaterial for the restoration of the inserted nasal mucosa. Such a combination perfectly fills the volume of atrophied tissue, is biocompatible, and does not cause inflammatory reactions. Details in the original publication https://doi.org/10.1371/journal.pone.0165265.

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FAQ

  • Can I be fully cured in one visit?

    We can't say for sure because each case is unique. Statistically, most patients require the re-administration of biotech products.

  • Will I be able to play sports after treatment?

    Moderate physical activity will be required. This will improve the sensitivity of the receptor apparatus (including the nose) to chemical agents present in the blood and surrounding tissues, as well as to environmental stimuli.

  • Can there be any complications after treatment?

    Since the administration is an invasive procedure, infectious complications, nosebleeds, etc., are possible. To avoid such consequences, the doctor conducts a thorough preliminary examination, studies the data from laboratory and instrumental tests, and, if necessary, adjusts for possible risks.

  • How soon after treatment will sleep improve?

    Sleep will improve significantly in 3-6 months. The restoration of impaired body functions, including sleep as one of the components, happens gradually.