Turbinoplasty: new way vs old way

In this video I discuss how turbinoplasty is performed. I describe the “old way” it used to be performed, by resecting the inferior turbinate. While usually a successful procedure it had the potential to cause a extremely frustrating and possibly permanent side effect, called “empty nose syndrome”. Submucosal resection of the turbinates has been around for over 30 years, but is a vastly superior method.
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[@likeawatch1]

After 30 years of sinus problems, I had tried everything. This was my last resort (I had it done 5 weeks ago) and it has changed my life. I honestly can't believe how good I feel.

[@howietianjamz6649]

Hey Matt im planning to get turbinate reduction using the least harmful way (the new way this guy talked about in the video). I've came across so many testimony videos on youtube about people regretting doing this because empty nose syndrome, and Im getting really scared about it. How has it been for you so far?

[@likeawatch1]

@@howietianjamz6649 my sinuses are about 75% improved.

[@mikes.4863]

@@howietianjamz6649 The people you saw talking about ENS were patients. They were not doctors. Regular people started telling the public about ENS before the doctors told us. What does that tell you about how much you can trust the doctors?

[@likeawatch1]

@@mikes.4863 my doctor told me he had done this procedure thousands of times and never seen a case of ENS. I believe him.

[@mikes.4863]

@@likeawatch1 Why do you believe him? He's just as capable of lying as any other human being.

[@marticusquarles3803]

Constant runny nose and sneezing, doesn't always mean something wrong with the body. Im young and dealing with vasomotor rhinitis, been dealing with it for 4 years now and it's annoying. I get allergy tested twice and both were negative. Got XRay and Cat Scan and both were negative. I didn't have no polyps or nothing in my nose. I do have a slight deviated septum, but I never had issues with breathing tho. H**l I even got blood work done and nothing, it was NEGATIVE. People always negative and forget that everybodys issues is different. People forget things change in the body, other than "there's something wrong in the body". Our body do have nerves all through it, so the sinus has a nerve and you know how nerves work, they do alot. And sometimes, nerves do overwork itself.

[@kiumarsazaripour3428]

For many years i had problem with my turbinate i could not sleep well, finally i reduction them in hospital ! Now i can breath very well , find a good ent surgeon and do it if you have breath problem

[@kmuttfg]

No thanks

[@357QueenBee]

Too late for me. Any advise on using Premarin ?

[@abbithompson2635]

Is inferior bilateral turbinate reduction a good way to do it?

[@AnkitSharma-hr6rl]

I had septoplasty turbinoplasty with microdribder. I am having trouble sleeping. I am feeling burning in my lungs. I am feeling lumps of dust in my throat. It has been 2 months now.Is this empty nose syndrome? I am feeling very scared There was fluid accumulation in my ear, the doctor said that DNS or Inferior turbinate enlargement should be done and he advised me to undergo septoplasty turbinoplasty with microdribder. I have to take a deep breath after a few minutes😢

[@timcepin3386]

Does this destroy the mucosa lining of the nasal cavity? Yes or no!

[@AdamGbl95]

Is this a completely different procedure than baloon sinuplasty for deviated septum? Can you get Empty Nose Syndrome from Baloon Sinuplasty or is that caused from turbinate reduction?

[@8perdonal]

baloon sinuplasty result are very unpredictable and its the same with doctor who says can correct septums cracking the nise with the hand....only breaks the nose and the simptoms come again.

[@AnkitSharma-hr6rl]

Sir Dr. it is said that just leave the epithelium and suck the bone and mucosa inside, sir will this cause empty nose syndrome please tell me😢

[@rlknight57]

I had the new procedure you describe about 8 years ago. It went very well and I was completely satisfied but the doctor told me the soft membrane would grow back in about 5 years and it did so now I have difficulty breathing again. How about the newest procedure called ablation?

[@davidandrew2429]

Hi @rlknight57, I had this done too. Did your turbunates grow back gradually or did you all of a sudden notice congestion?

[@rlknight57]

@@davidandrew2429 It was gradually and as the doctor had said about over a 5 year period.

[@davidandrew2429]

Hi @rlknight57 thank you for your response. I got radio frequency turbinate reduction march of 2022 and I feel some symptoms of empty nose syndrome. I’m hoping that my turbinates grow back

[@mikekaraoke]

@@davidandrew2429 And what turbinates were reduced, the whole point of having them done is if they are enlarged/swollen and been like that for at least a year or over. The Superior/middle turbinates should never be reduced or removed-just the inferior turbinates reduced!

[@AnkitSharma-hr6rl]

​@@davidandrew2429how are you know

[@MA-dm4xy]

What is this procedure called?

[@dwainborden9171]

Dr. Shellenberger I stumbled on your KZbin channel looking for a video on how to make my own saline solution (thank you) because I suffer from really bad sinusitis, and I would like to request if you would please do a video on what is considered mild, medium, and chronic or really bad sinusitis and what treatments are available.

[@Ib90]

Wow, i had this turbinate reduction but on my sheet it says out fractured with cauterization, i have these gian boogers since my surgery which was March 6, 2024 plus i get cold air sensation when i breath through my nose specially the left side when i am cold parking garage at my job. It only happens in the parking garage but outside cold doesnt cause this. Dies this mean i have empty nose syndrome or im just healing?? Help! 😭

[@m0rtuary143]

how are you doing now?

[@Ib90]

​@@m0rtuary143i recovered now thank god i dont have those symptoms anymore. It took 2 months to recover. Thanks for asking.

[@msgesus4518]

I had turbinoplasty where the bone was cut down, but supposedly the mucosa remains intact. Is that old school?

[@user-iw3qv2bo1s]

How are you know Is any problems with breathing

[@8perdonal]

no....the old school was turbinectomy.....the standart was cutin bone and mucosa....the problem was the recurrent crusts and the blood and agresivety......the change it cuting only bone and leave enough mucosa

[@brithegoddess]

ENS isn't a frustrating side effect. People have committed suicide because of it.

[@retropursuit992]

People have also commited suicide because of chronic rhinitis and sinusitis. It's a risk you take.

[@riccvven2078]

No they didn't, i had both and now ens Ens is a 1000 times worse, you can't treat it like a sinusitis

[@legendary2553]

@@riccvven2078how has the ENS been now?

[@bbyboybrzy]

@@legendary2553not sure she’s still around 😰

[@drinny26]

I saw someone on botched where the person entire turbinates were removed. They said they couldn’t function like a normal person.

[@sherrayortiz1022]

I have some questions about this does this guy have a real email?

[@pwk22]

Did you say that Empty Nose Syndrome is caused by the overabundance of crusting 2:00 ? I don't think that's right. I think ENS results from nerve damage in the resected turbinates that causes the brain to be unable to register air flow, which induces a sensation of asphyxia. Correct me if I'm wrong.

[@chookvalve]

I think ENS and crusting occurred simultaneously after resection in some cases.

[@nenadcubric2663]

Not everybody gets ENS maybe only 10%, but those 10%*suffer real badly

[@pwk22]

@@nenadcubric2663 Had I known of ENS, I would have been a lot more thoughtful in deciding to have my surgery. I was lucky.

[@regretsonly44]

What's the difference between this technique and using radiofrequency?

[@reefytide]

I just had radio I’m scared now

[@nenadcubric2663]

I did that and didnt help

[@regretsonly44]

If you could record doing this procedure it would be great !!! Also where are you located ?

[@arthurf6201]

Thank you Dr. Shellenberger, this was a great demonstration, along with the doodles! Unfortunately, I was given this same information by my ENT, who is a young, recently-educated guy like yourself, and went for a very conservative 15% submucosal resection. I'm over 2 months post-op and am still having some suffocation problems that I never had before, which makes me think I have partial ENS, at least on one side. I am a young, health male, so I didn't think the mantra of 'very very rare chance' would apply to me. So far it seems like I was wrong. :( If I had to do it over, I would have continued to suffer with my existing symptoms than live with what I have now. Please use turbinate resections as a last resort on your patients, even if it results in multiple FESS sessions.

[@sandeepgarcha4980]

2 month is early for nerve recovery you will recover give it some timr. Did u have Cold(Medtronics or Hot Olympus Diego) Microdebrider reduction. Did u have Outfracture. Any use of Cautery to stop bleeding? I think this disease is the outcome of Trigeminal Receptor injury. I hope u get well soon.

[@arthurf6201]

@@sandeepgarcha4980 I did not have outfracture and I don't believe any cautery was used. It should have been very safe. Thank you for the encouragement, we will see what happens as time goes on. My doctor told me recovery is usually one week, although when I told him how long I had been recovering, he said it was unusual, but not unheard of.

[@edu6032]

@@arthurf6201 How are you feeling now?

[@arthurf6201]

@@edu6032 Responding because I hate people who post something and then don't answer follow-ups. :) Better, but I still wouldn't have done the surgery.... or if I did, I should have only had it done on the symptomatic side, not bilateral like the ENT recommended. Left side is still a bit too open. LDN has helped a lot with inflammation and the triggered anxiety from breathlessness, which has become more of a rare event. Right now it is also the hot and humid time of year -- I guess we'll see how I feel once things get drier in the fall.

[@andrescuriel5505]

What about now? 😅

[@Vrga-en3sg]

Any type of these unnecessary procedures can cause extreme irreversible harm that is not fully discussed amongst patients. Turbinates are essential to the respiratory system and also have a neurological connection to alert the brain that you are breathing. Something goes wrong with these surgeries you have no way to reverse damages and are gas lighted by Ent dr.s until you are 6ft under.

[@Hshjshshjsj72727]

Why are you saying unnecessary procedure, obviously most of us have trouble breathing, mine is so bad that I even have blood pressure and stress since I was a teenager.

[@businessoffice4964]

My dad once told me that everything in your body has a purpose and you should really be careful about removing anything from your body. No way would I let a doctor stick that microdebrider in the nose of anyone I care about. Think about that people….would you want that thing stuck up your nose turning a grape into a raisin???

[@retropursuit992]

You would if you suffered from chronic rhinitis or sinusitis. I'm sorry but It's a awful, awful condition and it just worse as time goes on. I feel like I can maybe get in 30% of the air I used to get in, when I sleep it has to be on my back with my head propped up which results in my body sometimes forgetting to take breaths in or takes really shallow breaths. On top of all that I get chronic congestion, brain fog, memory problems, pain around my eyes, tinnitus, constant post nasal drip and extreme fatigue (I wake up every hour, that's just the ones I remember) My life is hell, everyday I think about doing something stupid, I left my job because I wasn't capable of functioning like a normal human being anymore. I think I'll take my chances with the surgery thanks.

[@donnawhite7020]

@@retropursuit992 im going through the same via covid

[@Monicanada1]

@@retropursuit992 how was it.. have you done the surgery?

[@retropursuit992]

@@Monicanada1 turns out I had a severe vitamin b12 and folate deficiency, got injections with top up nasal sprays and a lot of my symptoms are disappearing. Didn't think a little vitamin deficiency could be so severe 😂

[@adhdproductions4639]

@@retropursuit992 did you get the surgery any updates ?

[@nenadcubric2663]

Is allways, up to makes it

[@user-ef3ns8io5u]

All methods can lead to Ens. Turbinates should not be touched unless there is a tumor or cancer.

[@user-iw3qv2bo1s]

And if you can't breathe then what to do?

[@aryanchettri2251]

​@@user-iw3qv2bo1sthey'll breathe through mouth 😂

[@spooksyschannel3038]

Nasal sprays and allergy testing and allergy shots

[@timcepin3386]

Hasn’t worked for me.

[@Hshjshshjsj72727]

@@spooksyschannel3038those hardly work, I use fluticasone it is barely any help, my breathing is so bad I think it is leading to high blood pressure since I have that. I even saw an allergist and they didn’t know what I’m allergic to thats causing this daily problem.

[@toxiqnick604]

Pyriform turbinoplasty caused empty nose syndrome for me :(

[@nenadcubric2663]

Sometimes the old way works better

[@nighthiker8872]

Your videos are great.

[@nighthiker8872]

Could you share your channel? with others with the same views. To get more viewers.

[@mikes.4863]

Even if this surgery is safer, turbinate procedures are grossly overdone. If the turbinates are swollen and inflamed, it's because something is wrong in the body. The vast majority of people could likely get the turbinates to decrease in size simply by eating better. But they are lazy and doctors love money, so they will continue recommending turbinate procedures.

[@mcmag888]

Lazy? Or maybe just uninformed? Negative vibes from you ruin the good behind your message.

[@mikes.4863]

@@mcmag888 "Negative vibes from you ruin the good behind your message." THAT is the part of my message you focus on? My message being ruined is YOUR perspective. You don't just get to claim my message is ruined as if it's a fact. That's very arrogant. Other people got the main message because they know which part was most important. I'm concerned about saving people's lives, not on being "woke".

[@shadalereynolds5532]

I have a question so you think a person should go see a allergist before going to see a ENT ? Just because I realized doing my research that even if you do the turbinate reduction surgery you can still get them back unless

[@serop43]

I mean I dunno I thought this was an informative video for people who are researching deviated septum’s but what’s your suggestion? Don’t get one at all and stay a mouth breather cause I fuckin hate it 😂

[@mikes.4863]

@@serop43 So surgery is the ONLY way to fix congestion? Man, come on.

[@sandeepgarcha4980]

This disease seems to be caused by Doctors who dont beleive in ENS and do aggressive surgeries. Dr. Houser, Dr Nayak, Dr Das, Dr. Thamboo, Dr Otto, Dr Farag do these surgeries routinely and don't seem to have any Empty Nose Syndrome patient. ARS should appoint these doctors to train others about the techniques and pifalls to avoid this disease.

[@regretsonly44]

Do you think this technique is safe?

[@nathanthompson6562]

Annnnnnnnnnnnd i dont believe your claim with the DRs listed to have never gave anyone ens.

[@sandeepgarcha4980]

@@nathanthompson6562 If they did have any patient they would have reviews on google or other places.

[@nathanthompson6562]

@@sandeepgarcha4980 they did but they had the majority silenced and posts deleted. They had them banned from the forums like they had me. I'm one of the majority that had a negative experience with one of these drs. So stop the B's.

[@sandeepgarcha4980]

@@nathanthompson6562 Try Google to remove a review and you will find out that it is impossible to get them to remove a negative review. I am not talking about getting banned from Facebook. I am talking about Google and now a days most of the people leave reviews to display frustration on Google Reviews. I am not saying that you did not have a negative experience in getting ENS treatment from these doctors. I am saying that these doctors seem to have no cases of ENS when doing Septoplasty or turbinate reduction. Is it because they do surgeries more carefully. Did you have Septo/Turbinate surgery with one of these doctors or you were getting treament for ENS from previously botched surgery from some other doctor?