Dr. Steven Houser’s Empty Nose Syndrome Surgery

One of the world’s leading authorities on Empty Nose Syndrome, Dr. Steven M. Houser of Cleveland, Ohio, has spent his career pioneering efforts to treat this iatrogenic condition.

In his Foreword to Chris Martin’s book, Having Nasal Surgery? Don’t You Become an Empty Nose Victim, Dr. Houser describes how he first became aware of Empty Nose Syndrome:

“I first encountered Empty Nose Syndrome (ENS) during my fourth year of residency. I assisted Dr. X in nasal surgery that included septoplasties and turbinate reductions. I witnessed Dr. X take angled nasal scissors, press the cutting surface against the front of the inferior turbinate, cut and push the mucosa off the inferior turbinate, and finally withdraw a lengthy segment of mucosal tissue that looked like a long slug. I pulled packs from these patients’ noses the day after surgery and always prayed their bleeding would stop and I would not need to repack them.”

“Several months into the rotation I was in clinic with Dr. X. I picked up a chart to see the next patient who presented with nasal issues. I went into the room and introduced myself to a middle-aged African-American woman. She complained of nasal blockage and congestion, and her breathing seemed problematic. Dr. X operated on her nose several years prior and she was no better now; in fact she seemed worse.  Interestingly, she mentioned that she seemed to breathe better with a cold. Then I examined her and was shocked to see an enormous airway. I could see her soft palate with ease, as the inferior turbinates were just a small ridge on each side.”

“Why did this woman complain of poor breathing with such an open nose? I was baffled. I presented the case to Dr. X who hemmed and hawed and was unable to explain the symptoms either.”

“From that point forward I set out to answer why this might be and came in contact with Dr. Murray Grossman; we became fast friends. I began to think about ENS, and I researched the topic as thoroughly as possible. Eventually I decided to begin reconstructing these patients by simulating their missing turbinates. “

Empty Nose Syndrome Book

Here is a video of Dr. Houser performing surgery an ENs patient:

ENS Surgery

Dr. Houser uses Allograft tissue, a type of human donor tissue in his implant surgeries.

Not every ENS patient is a candidate for the surgery. Potential depends upon various factors.

The surgery does not produce, at this point, a perfect human turbinate.  It has, however, increased the comfort level of some ENS patients, including Chris Martin, author of Having Nasal Surgery? Don’t You Become an Empty Nose Victim.

Dr. Houser has written scientific articles on the subject of Empty Nose Syndrome, including:

Empty nose syndrome associated with middle turbinate resection
Otolaryngology – Head and Neck Surgery, Volume 135, Issue 6, Pages 972-973
S. Houser

http://oto.sagepub.com/content/135/6/972.full

Surgical Treatment for Empty Nose Syndrome

Archives of Otolaryngology Head and Neck Surgery. 2007;133:858-863

http://otoresearches.wordpress.com/2009/04/20/surgical-treatment-for-empty-nose-syndrome/

He donated his time to answer the questions of ENS patients on the Empty Nose Syndrome forum for several years:

Dr. Houser on the ENS Forum

MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109, USA. 216-778-8890

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~ by ens3 on March 10, 2010.

66 Responses to “Dr. Steven Houser’s Empty Nose Syndrome Surgery”

  1. Dear Dr. Houser,
    My name is Karen, I perfomed a septoplasty, turbinectmony and sinusectomy surgery on 30 October, 2015 in Brazil. And since then, I have been suffering from strange symptons, such as earaches, i feel a strong airflow through my nose, extremely unconfortable breathing, constant headaches, insomnia, depression, sadness, lack of energy to pursue daily activities and the feeling of cold air entering through my nostrils. The first ENT specialist caused chronic sinusitis I had to pursue other surgery to cure from it on 12 may, 2016 from another doctor, since I lost confidence in the first one.
    Although I had pursued that second surgery(etmoidectomy, sinusectomy and dacryocystorhinostomy on my right eye) to cure the chronic sinusitis, the symptons I declared earlier continued. I am suffering a lot, because the ENT speacialists in Brazil agrees that the turbinectomy pursued on me were very radical, but they do not speak about ENS and many do not believe that it existis. I have found only one Doctor here that works with implants for pacients with radical Turbinectomies and he uses hydroxyapatite, but I am not sure if that is best treatment option for my case. There were left 10% of right Inferior Turbinate, 60% of left Inferior Turbinate and a hole in the septum caused by the first surgery. My middle turbinates are intact.
    I would like to schedule an appointment with you, Dr. Houser. I want to seek treatment for my case abroad. I do not believe that the cure or relieve of my symptons can be found in Brazil.
    Thank you for your attention.
    Karen.

  2. Dear Dr. Houser,

    My name is Karen, I perfomed a septoplasty, turbinectmony and sinusectomy surgery on 30 October, 2015 in Brazil. And since then, I have been suffering from strange symptons, such as earaches, i feel a strong airflow through, extremely unconfortable breathing, constant headaches, insomnia, depression, sadness, lack of energy to pursue daily activities and the feeling of cold air entering through my nostrils. The first ENT specialist caused chronic sinusitis I had to pursue other surgery to cure from it on 12 may, 2016 from another doctor, since I lost confidence in the first one.

    Although I had pursued that second surgery(etmoidectomy, sinusectomy and dacryocystorhinostomy on my right eye) to cure the chronic sinusitis, the symptons I declared earlier continued. I am suffering a lot, because the ENT speacialists in Brazil agrees that the turbinectomy pursued on me were very radical, but they do not speak about ENS and many do not believe that it existis. I have found only one Doctor here that works with implants for pacients with radical Turbinectomies and he uses hydroxyapatite, but I am not sure if that is best treatment option for my case. There were left 10% of right Inferior Turbinate and 60% of left Inferior Turbinate and a hole in the septum caused by the first surgery. My middle turbinates are intact.

    I would like to schedule an appointment with you, Dr. Houser. I want to seek treatment for my case abroad. I do not believe that the cure or relieve of my symptons can be found in Brazil.

    Thank for your attention.

    Karen.

  3. Dear Dr Houser

    I just became an ENSURE victim after a surgery on 26th my 2016.
    I came to India for otolaryngology intervention and fell victim of a tubinectomy I was told will reduce the enlarged tubinates and allow free flow of air
    During surgery the 2 were removed instead leaving me with a gapping airways with air hitting straight to my lungs and sometimes food particles appear in my mocous from the nose after irrigation.
    Since the symptoms manifested on 10th July I have not slept well thus my BP has been on the rise.
    Can you help me…otherwise I can’t live this way anymore. I understand why some ENSURE Sufferers commit suicide
    I have ourself and

  4. Nice stuff! I like this post and am delighted to know that nose job and plastic surgery in Columbus Ohio really provide effective services. Expecting more such posts!

  5. My name is Bilane Djama.I live in Canada and I’m suffering ftom chronic atrophic rhinitis for
    2 years now and have lost some of my turbinates. I need a doctor who
    performes Young’soperation or a transplantation of cartilages or acrylic
    inside the nose to restore my lost turbinates in Alberta or elsewhere
    in Canada .My ENT isn’t able to help with this matter and I don’t know who
    else to talk to . Which doctors performes this operation in
    Canada ? .

    Many thanks
    © 2014 Microsoft Terms Privacy & cookies Developers English (United States)

    • I am sorry, I do not know of any doctors in Canada.

      • I’d like to thank the person who responded back to me .
        I need the alloderm implants performed in both my nostrils .I’d be grateful if someone has nore detail about this surgery .
        I want to know how long it takes to be done and most important how much it costs ?

        Thank you

  6. Are you aware of any university research in stem cells apllicable to ENS? Please advise name.

  7. sir i have ens but the right side turbinates are ok and the left side turbinates are removed by surgory .plz tell me what i do now.

    • ashfaq,

      I am not Dr. Houser. You may want to contact him at the address posted on this blog.

  8. Are their any doctors in Colorado. My sinus surgery in 2001 has total disabled me. Head pains I know he trimmed the turbinates on the first surgery, I think he removed them on the second. I got osteomyletis in sinus have three more surgeries to cure. Trigeminal and occipital nerve damage plague me. No one every suggested this but I have all the symptoms. Mouth breather. Just got sleep apnea machine. Had to get entire mask because nerves on side of face triggered by smaller masks. Wow to think my first ent did this makes me so angry. He died so I can’t sue him or I would. Urg. This stinks.

    • Jebby,

      I don’t know of any ENS doctors in Colorado. The closest I can think of to you is Dr. Murray Grossan, in California. A google search will turn up his info for you.

      I am so sorry to hear of what happened to you. So many similar problems to mine. It is so wrong.

    • he went to hell…

  9. Hola mi nobre es Andres y soy de Chiel y sufro los mismos problemas, para dormir uso algodones y 2 lavados diarios con agua isotonica, pero principalmente mis dificultades son la falta de aire disnea y sequedad ocular. pronto ere al Dr. hauser y espro en contar alguien con mismo problema en esa fecha, favor ponerse en contacto para viajar junto, la union hace la fuerza un abrazo desde Chile Andres

  10. Hola mi nombre es Andres y soy de Chile y sufro el mismo problema de la nariz vacia (ENS), para solucionarlo sobre todo en la noche uso algodones y 2 lavados diaris con agua isotonica, pero mi vida es un calvario sufro de disnea, sequedad ocular e incrmento de mi reflujo. estoy enviando todos los antecedentes al Dr. Houser para solucionar principalmente el vacio aere que se produce por el gran tamaño de la cavidades, espero que me pueda ver lo antes posble y escuchado algunos comentarios sobre el dinero que solicita este Dr. pero la verdad frente a un bienestar de tù salud esto pasa a un segundo plano. les mando muchos saludos que tengan esperanza y pronto estarè en los estados Unidos para buscar esta solucion, espero si hay algùn chileno que sufra esto u otros paciente con ste probelma que nos pongamos en contacto y vernos con el Dr. la union hace la fuerza. un abrazo desde Chile

  11. dr consider if your son is suffering from this type of problem ,how do uyou feel

  12. Why are my comments being removed? I have every right to let everyone know just what type of dr houser is; anyone WHI asks for cash for an operation; then changes their minds in what is wrong with the patient and then asking the patient if they want their file or “shall I destroy it?!” IS NOT A GIID DR! His technique may be good but when you diagnose a patient, you help them, you do throw them to the wind; many drs do this and it’s why we need reform; I’d go anywhere to have my nose work the way it was meant to, dr Houser’s little test proved that, but hanging a patient’s diagnosis because I asked if I was going to be in overnight or same day surgery is going too far; stepping in it!

  13. is Dr. Houser reputable? It seems he is the expert but I dont understand why he does not bill the insurance companies for the procedures as they would pay the majority of it. What has been people experience who have seen him?

    • ALSO, IF A DR ACCEPTS CASH, HE WON’T HAVE TO SAY ANOTHER DOCTOR MESSED YOU UP OR HAV ETO BE INVOLVED IN A LAWSUIT, IT’S THEIR WAY OF MESSING YOU UP AND YOU HAVE NO RECOURSE! BE WARY!

  14. please anyone suggest what i do to treat ,because i have lossed my turbinate two years before

  15. Hi i’m a 39yr old male from Michigan. I had surgery to fix a deviated septum 4 yrs ago. Initially my breathing was great. Now i believe i suffer from Ens. My Ent did not touch the turminates but only the cartiliage in my nose as well as septum. Now after years of suffering i;m told that i have a perforated septum. Ens also causes balance issues due to my ears so stuffed. I’ve had ct scans, hear tests and mri’s and nothing. This all began with my nose surgery. What should i do next?

    • I would try to see Dr. Steven Houser in Cleveland, Ohio.

    • Nate don’t get any more MRI’s wih contrast they leave gadolinium in your body and that is toxic heavy metal poisons! I have it in my blood and urine two years past the also test and no one wants to help me! Cathy

    • Find a better Ent Doctor. The very best one in Michigan that I would know is a Dr Michael Rontal off of orchard lake and north of 12 mile . Good luck

  16. Can smoking inflame nasal sinuses to make them feel a little narrower, or can it damage them?

    • I think smoking would be very dangerous to anyone with ENS as the protective membranes and cilia are compromised.

  17. Hi, I had endoscopic surgery on my lower sinuses and balloon surgery on the upper after a chronic sinus infection for a year. It has been a little over three months and when I breathe it feels like my sinuses are too large. My sister had the same surgery and she said it will probably go away after a year. Is this true? I told the Dr. office about this and they said that’s normal. Any advise will help, and a good ENT in St. Louis that treats ENS would be appreciated

  18. The only way Dr Houser will operate on you is to ask for money upfront outside on insurance, and he is unwilling to give you a letter of medical necessity so you can get some reimbursement from your insurance company. if he initially diagnoses you with Empty Nose Syndrome, he will then change his mind if you call the hospital (Metrohealh in Cleveland) to find out if you will be in same day surgery or overnight. Any dr who signs a contract to provide healthcare then reneges in his contract should be investigated to fullest extent of law. Any dr who diagnoses you with a condition them changes the diagnosis is suspect in my book. dr Houser does this I believe to xirumvent the fact that he would have to report he mistakes other doctors make. I wonder if metrohealth hospital is “onto him” doing surgery “under he table” for case alone. Beware of any dr like this that will “change” his original diagnosis!

    • Cathy, I am sorry for what happened to you. We are all in a horrible situation. I certainly understand your frustration. Unfortunately, I think Dr. Houser dares not to go out on a limb as there are too many ENT’s waiting to cut off that limb. The medical profession has become like a mafia. Any doctor who implies that another has done harm, or leaves open a door pointing toward that conclusion, is caught in the crosshairs. Thuggery and “brotherhood” are the order of medical care. Thus, it is possible for doctors to maim and kill without consequence. There are many who should be investigated before Dr. Houser, but the investigative agencies are part of the problem. It would be like expecting the mafia to investigate itself for corruption.

      • Well one thIngs for certain, there are Rico laws for Madia and there are JCOH laws too!

      • I’va faced the same issue with “doctors” covering other “doctors” and PO ENS. It’s a pity that as a patient, whose health and life was damaged, who lost everything in life because of this “doctor”, cannot even get justice or compensation since they made you a disabled person.

      • Anna, Yes, and even worse, a patient cannot even acquire appropriate diagnosis and treatment, as doctors abuse medical terminology to bury the patient’s condition.

    • I fear you have it wrong. The reason why Dr. Houser and Metrohealth needs upfront payments is because of the insurances companies..not him. He had a case where insurance gave the go ahead but then only covered $600 of the total cost. It resulted in the hospital telling him personally he needs to have upfront payments or would not be able to practice E.N.S. I have met with him and in my opinion he was an honest, kind doctor and person just wants to help. Its very sad how facts can get twisted.

      • Did Dr ouser first diagnose you then retract his opinion? I mean what type of doctor does that, if the symptoms are all the same no matter what? Dr Houser seems to have his little niche on the world and one day it will all come crashing down!

  19. I had septoplasty 4 years ago and i feel i breath 2 much air my mouth is so dry ny nose has been dry for years and my throat full of phelgm and i have this bad smell coming from my nose helpppp

    • You need to get a prescription for premarin for your nose. Do it as quickly as possible. If no ENT will prescribe it, order a plant estrogen cream. I believe there is one referenced here in the pages under “Dry Nose.”

  20. mia, It sounds like your problems are caused by afrin. If so, surgery will only make you worse. In most cases, turbinate reduction only causes problems anyway. Research afrin side effects and see what you can learn about how to cure the problems caused by long term use of afrin.

  21. Im not sure where to go but i need some help! I have a slightly deviated septum and enlarged turbinates. Was told by one ent that because I have dry nasal passages that he is unsure of doing surgery because of empty nose syndrome. Another ent told me that she suggests laser and burning scarring of my turbinates which will enable the turbinates to swell thus helping my chronic congestion. I have been dealing with this this for over a year now. Symptoms are congestion, post nasal drip and dryness..I have to mention that i have been on and off afrin for the last 15 years which has somewhat stopped working for me. Should i do the surgery? please any help and suggestions as i am severly tired and depressed!

    • mia, I would suggest that you see an ENT who understands Empty Nose Syndrome. I do not know where you live. Look up the blog “Empty Nose Syndrome Doctors” on this blog. It may also be possible to communicate with Dr. Murray Graossan on the Faebook Empty Nose Syndrome Awareness Page. You definitely need to get off Afrin as it causes rebound congestion. Should you do the surgery? In my opinion, no.

      • Thanks for your response. I’m definately trying to stop the afrin, even managed to stop using it for two months and the nasal rebound never would go away. That’s how I found out that I have a slight deviated septum and enlarged turbinates. I think the afrin has caused the enlarged turbinated that maybe only surgery could take care of. However, I already have nasal dryness and congestion that obviously would get worse if i have surgery. I feel like it’s a no win situation and have tried everything. I don’t know hoe people cope with empty nose syndrome, i feel miserable daily and get so preoccupied with it that it’s taking a toll on myself and family. I will take your advice and look for a doctor in my area (san Francisco, Ca. ) who specializes in empty nose. Thanks again!

  22. Hi i wanted to know if i am a victim of ens i have been to several ent consultants but they do not understand my problems. I live in the uk could you recommend anyone from the uk who has a understanding of this subject.

    Thankyou
    M Patel

    • I am sorry. I do not know of any doctors familiar with ENS in the UK.

      • Do people suffering with ens ever get swollen turbinates as when they get a cold etc? Or is it just constant empty?

        Also any docs in europe that can maybe shed a bit of light on my problems that you know of sir? . Its my left nostril that is extremely roomy after having septoplasty 18 months ago my right nostril seems fine as my septum deviates to that side even after correcting it. Only time i get comfort is when my left nostril closes. And i have found i only benefit from sleepin on my left as sleepin on my right side opens up my left nostrils and thisthen dry my mouth and my left side of throat. Its managable during the day but night sleepin is a nightmare with all trouble it involves. Regards M Patel

  23. I’m italian,i’m 24 years old….and one of the most famous doctor in italy for this area (Larosa) has done his diagnosis of empty nose sindrome..i have done 2 surgery in the past….a disaster….i feel ill…can i do a surgery in the USA to solve this problem?

    • Yes, Dr. Houser treats patients from many different countries.

      • Please I need help from Dr Houser. My 2ctubinates where yanked off just on 26th may 2016. I started feeling the openness on 22th July as the swellings subside

        I am in India delhi today but based i lagos nigeri please can I cemail medical reports plus recent CT over to you for assessment and help otherwise I’ll die of hypertension due to poor sleep

    • hey paolo, i’m an italian guy with the same problem… i live in the states and I have been helped with la rosa as well. I’m gonna go to be visited by doctor house soon. Give me your contact so we can keep in touch

  24. thank you for your responses to my questions

  25. I believe the statute of limitations for medical malpractice is either the time limit set by your state or, alternatively, it begins with the onset of symptoms. If symptoms begin 5 years after surgery, your statute of limitations of 3 years would begin 5 years after the surgery.

  26. David Slavit, M.D.
    787 Park Ave
    Phone: (212) 517-9177
    New York, NY
    “Some people are having more extensive removal than the amount of disease would warrant,” Slavit said. “Maybe we need to better evaluate who needs to have turbinates removed and who could get by with less aggressive surgery.”
    http://articles.latimes.com/2001/may/10/news/mn-61654?pg

    Wellington S. Tichenor, M.D.
    New York, New York
    212-517-6611
    http://www.sinuses.com/
    Dr. Wellington Tichenor’s explanation of empty nose syndrome
    “Too many surgeons today believe they can indiscriminately remove large amounts of turbinate tissue…” From Dr. Tichenor’s Introduction to Having nasal Surgery? Don’t You Become an Empty Nose Victim, book by Chris Martin..

  27. Is it still possible to sue a doctor for ENS after the statue of limitations has been met. In my state you have 3 years to sue for mal practice but my symptoms did not show up until 5 years after surgery?

  28. Is there a good doctor that can diagnose ENS in NY?

  29. Just subscribed to your interesting blog, will confirm in a minute. Please pm me on Facebook. Thanks! Catherine Nichols Pogorzelski

  30. I do not know of anyone. You could try to Dr. Houser in Cleveland or Dr. Das at OSU Medical Center in Columbus.

  31. who treats ens in cincinnati

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