Summary: Empty Nose No longer much of a mystery

Considering the results presented here it is not hard to imagine how some people at the very least could easily develop Secondary Atrophic Rhinitis (a surgically caused chronic dry nose also with many very unpleasant serious effects) or even worse, Empty Nose Syndrome. The risk of “S.A.R.” has been estimated by some to be as high as 20%.  I personally know through my own experiences of being at a severe low point in my quality of life and then seeing the benefits of progressive reconstructive surgeries that ENS theories are not theories they are facts. E.N.S. is not simply about the velocity of air in the nose or any one single issue. There are more than a few contributing factors:

  1. Huge declines in localized velocities as high as 75 to even 82%
  2. A pronounced redistribution of airflow from the upper nose to the lower empty cavity
  3. A large loss of physical structure and mucosa tissue
  4. A large increase in volume, especially in the cavity which no longer guides the air
  5. Increased turbulence and regions of recirculated air which is drying and destructive to the remaining tissue.
  6. Loss of a functioning nasal valve area by over reducing the diameter of the heads leading to loss of anterior velocity and less kinetic energy which is needed to evenly distribute the air into the cavity
  7. A loss of the nasal cycle so the remaining tissue can no longer swell and take turns resting from the destructive air currents in the over opened nose.
  8. Loss of actual nerve endings
  9. A localized loss of pressure and shear stress to activate the mechanical pressure sensing nerves that remain thus raising the threshold for activation of autonomic breathing reflexes
  10. A loss of moisture which negatively impacts the thermal sensing nerves due to the lack of a cooling effect felt as water constantly evaporates from the mucosa surface during inspiration. Dryness then leads to nerve pains in the nose. The prior pleasant cooling sensation is replaced by a burning sensation and the brain interprets this lack of feedback of proper air flow conditions as a suffocation alarm resulting in a near constant state of anxiety by activation of the “Fight or Flight Response”.
  11. Lack of resistance for your diaphragm to act against. I tried Bio-feedback breathing therapy and I found it impossible to pause my breathing at the tops and bottoms like my doctor thought was ideal until I used a restrictive nasal clip. I had to mechanically control my diaphragm to take slow even breaths in and to exhale slowly rather than have my lungs instantly collapse.
  12. Alveolar Gas exchange in the lungs is impacted causing less efficient O2 to blood transfer due to distal bronchioles not opening due to lack of negative pressure
  13. Chronic sleeplessness and exhaustion. This alone may be responsible for some of the mental/brain symptoms ENS patients experience. My sleep doctor told me that you could take an Olympic athlete and if you chronically deprived them of sleep that they would be similar to me.
  14. Adrenal fatigue.
  15. Nasal crusting and the growth of bad bacteria
  16. Loss of Cilia function and transport
  17. Regarding the cavity and radial slit: For every doubling of slit size in mm you lose roughly 50% in velocity, 85% of your negative pressure and 72% of your sheering forces