Possible breathing issue and ENS from rhinoplasty?
Hi.... I recently had a rhinoplasty (secondaray revision), and I have noticed 9 weeks after that I am still a bit stuffy (sometimes more than others, like when I sleep). I'm also experiencing dry nose, some crusting, dry mucous, and a slight burning sensation. I just found out through an ENT, who was not the surgeon that performed this rhinoplasty, that my terbinates were partially removed and that my nasal passages close up during deep inhalation (he used a scope to do this). First off, can a surgeon remove even part of your terbinates during a rhinoplasty without your knowledge or conscent? Or is this something that was done accidentally or carelessly because he was breaking and resecting bone which could have included my terbinates? Second, since mine appear to be partially removed can this contribute to the dry, burning, stuffy sensation I'm feeling otherwise called "empty nose syndrome"? The doctors I've gone to tell me that this is a temporary side effect of the surgery especially since it is my second one (the first was done 20 years ago) and that it will very possibly heal in time as the nose "adjusts". I'm really hoping this is the case since I still am in recovery as it takes a year for something like this to heal. I also have heard that terbinates can regenerate if they haven't been removed totally. Is this true? I don't want long term problems due to this. The surgeon who performed the surgery never told me that in order to reduce the shape and size of my nose, he would need to partially remove my terbinates as he also never mentioned that my nasal passages would be affected as a result of the reduction. Any information would be much appreciated. Thank you very much.
Your questions regarding surgical technique and the scope of surgery, in the performance of a rhinoplasty, are beyond my areas of expertise.
You state, “I just found out through an ENT, …”. That ENT would be the best person to answer your questions, especially about the appropriateness of turbinate removal and other surgical actions etc in the performance of a rhinoplasty.
Your questions regarding what you were told pre-operatively and the surgery that was actually performed, relate to the issue of, Informed Consent. You may want to review the Informed Consent you signed and share it with the second ENT for his/her opinion and share it also with one or both of the organizations listed in the next paragraph.
Any issue you may take with the surgeon who actually performed the surgery should be based upon what is called, “Standard of Practice” and that is also information to be gleaned from the second ENT and/or the ENT Specialty Practice Board of the AMA and/or the American Academy of Otolaryngology (http://www.entnet.org/)
Keep in mind that subtle postoperative changes continue for many months following surgery.
And, be guided by the following: It is the fundamental responsibility of the surgeon to balance the wishes and desires of the patient with what is realistically possible given the anatomic limitations (or possibilities) inherent in each individual nose.
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