FAQs

Balance Testing

How long is the ENG testing and what is it?

The Electronystagmography (ENG) test provides important information about the balance mechanism of the inner ear. This test tracks eye movements that offer information about the balance system. There are three main parts of the ENG.

The tracking tests measure eye movements as your eyes follow a visual target.
The positional tests measure dizziness while sitting with your head in different positions.
The caloric tests involve running cool and warm air into the ear canal. This change in temperature stimulates the inner ear, causing rapid movements of your eyes. The final portion of the test may give you a sensation of moving that will dissipate rapidly.

The entire ENG test will take approximately an hour. If you have been scheduled for this test, please refer to this form for instructions on what to do before your testing.

Empty Nose Syndrome

Empty Nose Syndrome

Empty Nose Syndrome (ENS) is a very difficult condition caused by damage to the inside of the nasal cavity, usually associated with surgical resection of tissue. Many patients who experience these symptoms will have problems with their nose which are counterintuitive in their presentation.
Intial work by Dr. Eugene Kern (formerly Mayo Clinic, Rochester) established that a condition of atrophic rhinitis is created in some patients after nasal surgery. This leads to feelings of paradoxical nasal obstruction and significant crusting or nasal dryness. In general, most patients who experience ENS have some form of turbinate reduction or removal. You can see this video lecture from Dr. Kern where he explains his findings and medical rationale.

The phenomenon of ENS is not universally accepted in the ENT/Otolaryngology community and as such is not universally treated. Fortunately, the condition itself is gaining wider acceptance and more physicians who treat sinus and nasal disorders are becoming familiar with it. The American Rhinologic Society does acknowledge that it is a condition and they do have it listed on their website as such.

The diagnosis of ENS is somewhat difficult but can be suspected when either physical examination or imaging indicates a large removal of nasal tissue which contributes to the airflow. This can be tissue of the inferior turbinate, middle turbinate, or medial maxillary wall. A “cotton test” was initially proposed as a relatively simple way to determine if increasing resistance the nasal cavity would alleviate patient symptoms. Sometimes this can be done too good effect and be significantly helpful in determining the diagnosis. Dr. Kern, had done significant work on rhinomanometry or nasal airflow analysis to provide an objective root of diagnosis.
The overall incidence of ENS after nasal surgery is unknown. Because there is no uniform definition nor uniform acceptance within the profession, there has not been a large-scale study of the number of patients who encounter this condition after nasal surgery. Dr. Kern and Dr. Eric Moore, published a case study of 242 people with atrophic rhinitis attributable to ENS. This was the first known reference in the scientific literature to such a condition. The origins of the condition of atrophic rhinitis is discussed as well as measures of prevention, and some suggestions of treatment in this article.

It is important to understand as a patient if you have seen healthcare providers that have dismissed the symptoms that you seek out physicians who are knowledgeable in the area of Empty Nose Syndrome. There are several occasions where patients have become violent or committed suicide when they felt as though the health care system did not recognize their unique condition. If you are having problems please consider talking with your primary care physician and research your local Otolaryngology physicians to determine which ones have experience with Empty Nose Syndrome.

I have accumulated a list of helpful websites that may get you started on educating yourself. The first link is the most important. The Empty Nose Association. They are a wealth of information for patients that are having issues. Also of significant help is the book, "Having Nasal Surgery? Don't You Become an Empty Nose Victim!" by Christopher Martin.

Imaging

Medications

OTC Nasal sprays for allergy you can use: Over the last five years there has been a large number of prescription medications made available to patients over the counter. The medications that you once had to go to your healthcare provider now can be purchased in every pharmacy, most grocery stores and even in some convenience stores. I recently did an interview on KOLO TV talking about the different kinds of nasal sprays. You can see that interview here. This interview focuses on the main nasal sprays that are steroids for allergy. This can be particularly helpful for you if you are having seasonal allergy problems such as watery eyes, itching and sneezing. Remember! If you use these medications you need to be patient and try them for 7-14 days consistently to see if they help. As always, read and follow the directions on the bottle. If they help then GREAT! If not then consult your healthcare provider. Dr Hudson

Sinus procedures

Sinus procedures: Intro to Balloon sinus dilation vs Sinus Surgery (FESS): Balloon Sinus Dilation is a relatively new procedure that patients can undergo in the office to help treat chronic sinus issues. If you have been having problems with facial pressure, headache pain, congestion or stuffy nose. And it has been accompanied by a thick, yellow-green nasal discharge or a low fever this may be an option. Some of the advantages that the in-office balloon procedure may provide are that it has a quick recovery and in most cases is more cost effective for the patient. It is a permanent procedure and can be used in almost all patient populations. A useful website to visit is the sinussurgeryoptions.com website which will walk you through your symptom complex and educate you further about how sinus balloon dilation works! If you would like to see how the balloons actually work you can see a video of that here. If you would like to see actual sinus surgery you can see a video of that here.