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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.
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 cerebrastenic 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.
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.
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.
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.
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.
● 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.● Administration of MSCs from of adipose tissue (autologous or donor`s).● Intranasal injection of the three-component graft with methylcellulose, cell-free lyophilized adipose tissue matrix, and mesenchymal stem cells. This innovative method, which was specially developed by the team of GOOD CELLS biotechnologists, is used to correct the volume of the nasal sinuses.
The second and third 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!
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.
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.
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.
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. 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.
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.
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?
We expect sleep improvement during 3-6 months. The restoration of impaired body functions, including sleep as one of the components, happens gradually.
Is it possible to create a new functional connective tissue of the nose with ENS?
The three-component graft with methylcellulose will turn into connective tissue and inherit all its characteristic functionality. The tissue will be nourished by blood. This piece of tissue will naturally complement the architecture of the nasal conchae.
Is it possible to regenerate nerves?
Sleep will improve significantly in 3-6 months. The restoration of impaired body functions, including sleep as one of the components, happens gradually.
What treatment at Good Cells is available for patients without structural changes with symptoms such as loss of air sensation, mucosal dysfunction, nerve damage, nervous system dysfunction?
The symptoms described are probably related to damage to the tissues of the nose. By restoring the functionality of the tissues of the nose, we eliminate these symptoms. However, it is important to diagnose the root causes of this destruction. We need to see the patient's medical materials to say more.
Is it possible to restore significant losses of blood vessels and nerves in the tissues of the nasal sinuses?
Nerve regeneration is possible at least partially. We offer an additional injection of neural crest-derived stem cells to patients who need nerve regeneration. This cell type has the ability to stimulate the regeneration of the peripheral nervous system. This injection will help to restore the partially lost receptor apparatus of the nasal cavity.
Is it possible to restore the thickness of a very thin nasal septum?
Septum defects are very different. Please send your medical materials for review. It is very difficult to make a septum thicker (from a technical point of view). We can only improve the function of the mucous membrane of the septum without its thickening.
Is methylcellulose a permanent filler, or it absorbs?
A three-component graft with methylcellulose is an organic filler that is partially exposed to lysis. Thus, part of the injected volume remains forever, turning into connective tissue. The volume retained depends on the lysis activity.
Is it possible to implant donor cartilage from the ribs after methylcellulose injections?
Yes, it is possible, but only in a treatment protocol agreed upon between doctors. In Ukraine, there are temporary legislative issues regarding transplantation of donor rib cartilage.
Is it possible to increase the volume in all parts of the nasal cavity (head, body, tail)?
Theoretically, yes, but the possibility of injection is determined by the task of correction, the current state, and the presence of living tissue with the presence of nourishing. The damaged structure of the nose does not always allow injections to be made everywhere. This is determined by the doctor. As a rule, it is made in the “head” of the turbinate, as it’s easier to reach a positive effect and less risk of complications.
Do Good Cells performs a cotton test to know exactly where to add volume?
Yes, we do the cotton test if needed. Compulsory tests are always rhinomanometry, endoscopy. Other tests if needed.
Does the atrophic tissue regenerate after injection? Does it improve the scar tissue after injection?
Dead tissue is not regenerated. The scar tissue can partially change the structure, it depends on the nature of the scar.
Do you do ENS6Q before and after the injection to monitor the progress of the patients?
We carry out obligatory diagnostics before the program, before starting treatment, a month after, and 3 months after treatment. Diagnostics includes analyzes, questionnaires at each stage of treatment, rhinomanometry, endoscopy, CT, and MRI as prescribed.
Please contact us, our managers are always ready to answer your questions. Consultation by phone is completely free and does not oblige you to anything.We will be happy to provide you with comprehensive information so that you could make the right choice!