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The Mystery of Empty Nose Syndrome

Brett Helling had surgery to correct a deviated septum in hopes that it would help his frequent sinus infections. Afterward, he suffered from an inability to feel himself breathe. He felt like he was constantly struggling for air. Doctors couldn’t find anything wrong, and he was eventually diagnosed with depression. Through his own research, he’d found something called “Empty Nose Syndrome,” which plagued a small minority of people who had turbinate reduction surgery. Only later did he find out that his turbinates had been reduced during the surgery. But he still couldn’t find a doctor to help him.

Inside your nose are two bony shelves divided by your septum, and these shelves contain three sets of turbinates. Each side of the nose contains a low, middle, and high turbinate. The low one, called an inferior turbinate, is the biggest — like a small cigar, about five or six centimeters long — and inside the inferior turbinate are blood vessels that can swell and shrink dramatically. (Imagine a penis and you’re not far off.) Turbinates help regulate airflow through the nose and also warm, filter, and humidify the air using a moist outer lining of tissue called mucosa.

Allergies, sinus infections, and other conditions can cause the inferior turbinate to stay enlarged, which leads to nasal blockage. If that’s the case, and if antibiotics don’t work, it’s not unusual for an otolaryngologist to recommend reducing the inferior turbinate (and, in rare cases, the middle turbinate).

There are a couple of doctors who are researching Empty Nose Syndrome, and one who is doing turbinate reconstruction. But it was too late for Helling. Read his story and the story of Empty Nose Syndrome at Buzzfeed. 

(Image credit: Mauricio Alejo)

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They are credited with recovering moisture in our exhaled breath, also. This is particularly important for warm-blooded animals, because our warm breath can carry significant amounts of moisture out of our bodies. Some paleontologists have speculated that the relatively large turbinade bones found in dinosaur skulls imply a warm-blooded metabolism for them.
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An interesting thing about the blood vessel swelling is that it can reduce the flow of air through one of the other nostril. This restriction alternates between the left and right side. Why? Because when we smell things, the smell receptors become saturated after a while, and stop responding. Rather than lose the sense of smell entirely, the sense is passed off from one side to the other, allowing the occluded side to refresh itself.
(I cannot remember where I read this. It was in some science magazine like Nature or Science)
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