Dear ENS Community,
We are attaching an update on our efforts to prevent, treat, and cure empty nose syndrome. We hope you will find it useful.
1.How have your initial results been for injection therapies for ENS?
We have injected approximately 50 patients this year with primarily a combination of platelet-rich-plasma and Matristem (soluble collagen and laminin fibers). We have experienced positive results for most of our patients. Approximately 80% of our patients have reported benefit from an injection. We have not received any followup from 12% of our patients. 6% of our patients have reported no improvement from an injection and 1 patient reported that his symptoms of dryness and obstruction were worse after the injection. We have not had any severe procedural complications during or after the procedure. We have had some patients who had difficult access for venipuncture, several patients who had some mild bleeding after the procedure, and 1 patient who felt like fainting just prior to the procedure. In terms of benefit, this has ranged from a mild-moderate initial benefit that has only lasted 1-2 weeks and then returns to the patient’s pre-injection condition to patients who have had life-changing results with significant reduction in their nasal congestion, significantly improved sleep, and an ability to return to their normal lives. We have witnessed actual turbinate regrowth now in several of our patients who have received multiple injections. Approximately 1/3 of our patients have returned for multiple injections, with one patient currently on her 8th injection. All of our patients who have received multiple injections have reported added benefit from each repeat injection except for 1, who received 2 injections and reported that he received minor benefit from each injection that dissipated relatively quickly.
2.Are you now offering implant surgery?
We have had a few remarkable results for patients with sinus disease, for whom we have provided a platelet-rich lipoaspirate and fat graft, combined with platelet-rich plasma and Matristem sheeting. One of our patients regained her sense of smell after 28 years of loss of smell. We have seen significant benefit for nearly all of our initial patients with chronic sinusitis that we have tried this for. As a result, we will begin offering this surgery under general anesthesia for selected patients with ENS that we feel would benefit from a tissue implant. In addition, we have been able to get partial insurance coverage for the procedure. We will offer a combination of PRP, PRL, and Matristem sheeting for patients. This procedure will require general anesthesia, and fat is removed from a patient’s abdomen for this procedure, so it is a bit more complicated than an injection under local anesthesia.
3. What progress has been made on patient advocacy?
We have completed a one-page informational handout about Empty Nose Syndrome that will be made available on the American Rhinological Society website. This should enhance both patient and physician awareness about this disease. This should be available on the ARS website shortly. We will report on other advocacy and research items in progress shortly. Please visit our website at www.usasinus.org or email us at usasinus@gmail.com for more information.
Best wishes,
Subinoy Das, MD, FACS
US Institute for Advanced Sinus Care and Research
We are attaching an update on our efforts to prevent, treat, and cure empty nose syndrome. We hope you will find it useful.
1.How have your initial results been for injection therapies for ENS?
We have injected approximately 50 patients this year with primarily a combination of platelet-rich-plasma and Matristem (soluble collagen and laminin fibers). We have experienced positive results for most of our patients. Approximately 80% of our patients have reported benefit from an injection. We have not received any followup from 12% of our patients. 6% of our patients have reported no improvement from an injection and 1 patient reported that his symptoms of dryness and obstruction were worse after the injection. We have not had any severe procedural complications during or after the procedure. We have had some patients who had difficult access for venipuncture, several patients who had some mild bleeding after the procedure, and 1 patient who felt like fainting just prior to the procedure. In terms of benefit, this has ranged from a mild-moderate initial benefit that has only lasted 1-2 weeks and then returns to the patient’s pre-injection condition to patients who have had life-changing results with significant reduction in their nasal congestion, significantly improved sleep, and an ability to return to their normal lives. We have witnessed actual turbinate regrowth now in several of our patients who have received multiple injections. Approximately 1/3 of our patients have returned for multiple injections, with one patient currently on her 8th injection. All of our patients who have received multiple injections have reported added benefit from each repeat injection except for 1, who received 2 injections and reported that he received minor benefit from each injection that dissipated relatively quickly.
2.Are you now offering implant surgery?
We have had a few remarkable results for patients with sinus disease, for whom we have provided a platelet-rich lipoaspirate and fat graft, combined with platelet-rich plasma and Matristem sheeting. One of our patients regained her sense of smell after 28 years of loss of smell. We have seen significant benefit for nearly all of our initial patients with chronic sinusitis that we have tried this for. As a result, we will begin offering this surgery under general anesthesia for selected patients with ENS that we feel would benefit from a tissue implant. In addition, we have been able to get partial insurance coverage for the procedure. We will offer a combination of PRP, PRL, and Matristem sheeting for patients. This procedure will require general anesthesia, and fat is removed from a patient’s abdomen for this procedure, so it is a bit more complicated than an injection under local anesthesia.
3. What progress has been made on patient advocacy?
We have completed a one-page informational handout about Empty Nose Syndrome that will be made available on the American Rhinological Society website. This should enhance both patient and physician awareness about this disease. This should be available on the ARS website shortly. We will report on other advocacy and research items in progress shortly. Please visit our website at www.usasinus.org or email us at usasinus@gmail.com for more information.
Best wishes,
Subinoy Das, MD, FACS
US Institute for Advanced Sinus Care and Research
