Secondly, I read the story on sinu-clear laser surgery. I am not familiar with this particular surgery, although it does seem interesting. However, some people who have laser surgery to reduce their turbinates end up with a similar version of empty nose; Dr. Houser calls this "ENS-Type" as they have sufficient turbinate tissue remaining but still experience some empty nose symptoms, such as paradoxical congestion. You see, the laser surgery, in this instance, damages the outer layer of nasal mucosa in order to reduce submucous turbinate tissue - the inner layer, damaging both in the process. So that's a bad experience with laser surgery. Dr. Houser has corrected these patients with alloderm implant, which has helped.

Are you familiar with sinuplasty surgeries "balloon sinuplasty" and the success/failure with it? I would think it would be neat for the pnd website to do an article on it. I wonder if it is a fad or here to stay.

Lastly, just want to comment on your statement: "To think that one’s sinus problems could be so miserable as to make a person uproot their homes is pretty drastic." Unfortunately, that is how I - and others - sometimes feel with empty nose. The cold, dry air in winter makes dealing with this problem tough. People in warm, moist climates appear with empty nose appear to cope better in the winter, since our noses have lost the turbinates, which humidify, warm, and filter air. I was just talking with an empty nose sufferer from MA who plans to move to Florida in the winter, which brings him immediately relief, maybe 25-50%.

Thanks for the article, Walt. Keep up the good work on the pnd site!

Chris"

My response to Chris was as follows: “Chris, In fact we do have an article on sinuplasty on our site: www.postnasaldrip.net/sinussurgery.htm.

I agree with your comments about pulsating nasal irrigation. I’ve mentioned it to many people over the years, but few really buy the machine and try it. I don’t know if it is the money to purchase the machine or if it just seems “weird" to people. I tried using a neti pot before finding Dr. Grossan’s books, and it really didn’t work for me well at all. Also, the saline solution I used at the time was too strong for me. Even Dr. Josephson in his new book treats both methods as being of equal utility, but he personally uses the pulsating method, which tells you something. He didn’t mention the benefit of inciting cilia to move and function, if memory serves, and this is the main thing Dr. Grossan pushes all the time. There is no way for me to know for certain if my cilia start moving after nasal irrigation- all I know is that I’m much better using pulsating irrigation and can now control sinus infections for the most part.

I’ll pass your comments about laser surgery on to Jason, the person who had the operation done. He should be made aware of this.

I can imagine that living in a cold climate would be really tough for ENS sufferers. I’ve noticed that when we are in Europe (about 2 months per year- in the summer normally) I rarely need to do nasal irrigation, although I have a travel water pik for that purpose. I don’t know if it’s the humidity or what. Another person on our list from Texas, (who actually wears some sort of filter at work every day to avoid high levels of fungus in his office!) said he felt much better on a recent trip to Italy. Environment definitely plays a part. I use a humidifier in our home and measure the level as well, but it’s not the same.

Again, looking forward to reading your book in June. WB