ENT Doctor in Istanbul

21/02/2026

Endoscopic Nanofat Injection to Inferior Turbinates in Empty Nose Syndrome

https://www.ent-istanbul.com/2026/02/endoscopic-nanofat-injection-to-inferior-turbinates-ens.html

Empty Nose Syndrome (ENS) is a complex clinical condition characterized by paradoxical nasal obstruction, cold and dry air sensation, burning, dyspnea, and significant loss of quality of life, often occurring after aggressive turbinate surgeries. The pathophysiology of ENS is not limited to mechanical volume loss; it involves multiple components such as mucosal atrophy, submucosal fibrosis, microvascular insufficiency, and neurosensory dysfunction. Therefore, structural filler approaches alone are often insufficient in treatment, and interest in regenerative therapies is increasing. We performed endoscopic turbinate nanofat injection procedures on a patient with symptoms of empty nose syndrome following previous turbinate procedures.

Nanofat injection to inferior turbinates in Empty Nose Syndrome: preparation, regenerative properties, benefits, limitations and technical challenges.

21/02/2026

Regenerative Treatments for Empty Nose Syndrome | Microfat, Nanofat, SVF & MFAT

https://www.ent-istanbul.com/2026/02/regenerative-strategies-in-empty-nose-microfat-nanofat-svf-microfragmanted-fat.html

Empty Nose Syndrome (ENS) is one of the most challenging conditions in rhinology. Despite an objectively wide nasal airway, patients experience paradoxical nasal obstruction, dryness, air hunger, and severe impairment in quality of life. ENS is not simply a problem of airflow—it represents a complex interaction between turbinate volume loss, mucosal atrophy, microvascular damage, fibrosis, and neurosensory dysfunction.

In recent years, autologous adipose tissue–based regenerative therapies have gained increasing attention as potential treatment options for ENS. Unlike synthetic implants or purely structural solutions, fat-derived approaches aim to restore both anatomical volume and biological function of the nasal mucosa.

This short video provides a concise, clinically focused comparison of four major adipose-derived techniques used in ENS management:

Microfat is primarily a volume-restoring technique. By preserving viable adipocytes, microfat injections can partially recreate turbinate bulk and help redirect nasal airflow. However, its regenerative capacity is limited, and graft survival depends heavily on local vascularity.

Nanofat contains minimal viable adipocytes but is rich in stromal cells, growth factors, and cytokines. Its primary role in ENS is not volume replacement, but improvement of mucosal quality, angiogenesis, and tissue remodeling—making it particularly useful in atrophic and fibrotic nasal mucosa.

Stromal Vascular Fraction (SVF) represents the most cell-rich option, containing adipose-derived stem cells, pericytes, endothelial progenitor cells, and immune-modulating cells. SVF offers strong regenerative and anti-inflammatory potential, but provides little structural support and faces regulatory and standardization challenges.

Microfragmented Fat Tissue (MFAT) bridges the gap between structure and biology. By preserving adipocytes, stromal cells, and extracellular matrix in a minimally manipulated form, MFAT offers both volume stability and regenerative support. This hybrid nature makes MFAT especially attractive in selected ENS patients with combined volume loss and mucosal degeneration.

This video highlights the advantages, limitations, and clinical roles of each technique, emphasizing that no single method is universally curative. ENS treatment must be individualized, often requiring a multimodal strategy that balances airflow mechanics with mucosal regeneration and neurosensory support.

Clinical overview of adipose-derived regenerative therapies for Empty Nose Syndrome, comparing microfat, nanofat, SVF and MFAT.

18/01/2026

https://www.ent-istanbul.com/2025/12/non-cross-linked-ha-filler-turbinate.html

Non-cross-linked hyaluronic acid turbinate injections as an experimental approach to improve airflow sensation in Empty Nose Syndrome.

18/01/2026

https://www.ent-istanbul.com/2025/12/big-nasal-septum-perforation-closure.html

Endoscopic before-and-after video of successful repair of a large 6×3.5 cm nasal septum perforation with surgical outcome.

18/01/2026

https://www.ent-istanbul.com/2026/01/fourth-revision-rhinoplasty-for-severe.html

Fourth revision rhinoplasty for a severe C-shaped crooked nose, highlighting surgical challenges, techniques, and postoperative results.

18/01/2026

https://www.ent-istanbul.com/2026/01/dual-graft-technique-for-nasal-septum.html

14/12/2025

https://www.ent-istanbul.com/2025/12/complicated-4th-revision-rhinoplasty-bloocell-sheet-type-pcl-removal.html

Complex fourth revision rhinoplasty with Bloocell Sheet-Type PCL removal and temporal fascia grafting for safer, natural structural nasal repair.

14/12/2025

https://www.ent-istanbul.com/2025/12/non-cross-linked-ha-filler-turbinate.html

Non-Cross-Linked HA Filler Turbinate Injection For ENS Symptoms



We administered a non-cross-linked gel filler turbinate injection to a patient with symptoms of empty nose syndrome. Unlike classic cross-linked HA fillers, these products, packaged in 2ml sterile syringes, offer a greater volumizing effect with a single injection, except for the risk of rapid absorption and temporary relief. Classic cross-linked HA fillers are generally sold in 1ml sterile syringes. They are usually more expensive than non-cross-linked HA fillers and take approximately 10-12 months to decompose in the body.

Hyaluronidase activity is not homogeneous in the body. It is most abundant in tissues with rapid extracellular matrix turnover, high vascularization, and active cell migration. This enzyme activity is particularly high in mucosal surfaces, especially the nasal mucosa and turbinate. Therefore, the mechanical volume increase effect after injections of non-cross-linked HA fillers is very short-lived. However, with repeated injections, the regenerative effect may become more pronounced with the combined effect of salmon DNA and vitamin B3. More detailed results can be obtained after comprehensive scientific studies.

The images above and below show the left inferior turbinate before, after, and after injection of non-cross-linked HA filler (1ml and 2ml). Following the injection, the gap between the left inferior turbinate and the nasal septum was significantly closed. The patient reported feeling quite satisfied and well at this stage. Unfortunately, this effect almost completely disappeared after 2 weeks.

With the patient's permission and knowledge, we injected Kiara Reju, a non-cross-linked skin mesotherapy product containing Hyaluronic Acid (HA), (Salmon DNA), and Niacinamide (Vitamin B3), into the left inferior turbinate.

About the Product (source link: Kiara Reju skin booster):

Kiara Reju PDRN Skin Booster is a skin booster/biorevitalizant formula designed for skin rejuvenation and revitalization. This product is generally preferred for professional use in mesotherapy, micro-needling, or similar dermal applications.

🧪 Main Ingredients

PDRN (Polydeoxyribonucleotide) – Typically ~5 mg/ml
→ Supports tissue renewal and cell proliferation; provides anti-aging effects.

Hyaluronic Acid (HA) – ~20 mg/ml
→ Provides strong moisture retention and plumping in the skin; increases elasticity.

Kiara Reju PDRN Skin Booster
Niacinamide (Vitamin B3) – Approximately 1 mg/ml
→ Exhibits anti-inflammatory properties, helps even out skin tone, and may reduce post-treatment irritation.

In my patient's feedback, they stated that the effect decreased much faster after the injection, approximately 7-10 days, compared to the cross-linked HA filler, and that they were more satisfied with the cross-linked HA filler injection. We also administered a high-volume PRP injection (approximately 20ml) to the same patient, and they stated that even with the PRP injection, the effect lasted longer than with the non-cross-linked HA filler, although less than with the cross-linked HA filler.

Comprehensive scientific studies are needed on this subject, and stem cells, fat injections, and HA filler injections can be used as adjunktive products in treatment.

To read other articles about empty nose syndrome prepared by Dr. Murat Enoz and published on this website, you can click on the search result link (you can access other articles by clicking on "more posts" at the bottom of the opened link) >> https://www.ent-istanbul.com/search?q=empty+nose+syndrome

31/10/2025

https://youtu.be/Jpll12yDXZc

This CT scan demonstrates a left-sided nasal septum deviation with a prominent bony spur contacting the left inferior turbinate. Such mucosal contact can lead to a contact point headache, presenting as facial pain or pressure on the affected side. A left maxillary sinus retention cyst is also visible as an incidental finding.

https://www.ent-istanbul.com/2018/10/ossified-overhang-osteophyte-bone-spur.html
https://www.ent-istanbul.com/2018/06/nasal-bone-spur-removal-can-reduce-your-headache.html
https://www.ent-istanbul.com/2018/04/nasal-bone-spur.html
https://www.ent-istanbul.com/2018/03/nasal-bone-spur-atypical-headaches.html

This CT scan demonstrates a left-sided nasal septum deviation with a prominent bony spur contacting the left inferior turbinate. Such mucosal contact can lea...

29/10/2025

Cribriform Plate Fracture After Head Trauma: Symptoms, CT Findings, and Treatment Options

https://www.ent-istanbul.com/2025/07/traumatic-cribriform-plate-fracture.html



A cribriform plate fracture is a rare but serious complication of head trauma, often involving the delicate bone between the nasal cavity and the brain. This fracture can disrupt the barrier between the sinuses and cranial cavity, leading to cerebrospinal fluid (CSF) leaks and an increased risk of meningitis.

Symptoms of a cribriform plate fracture may include clear nasal discharge (CSF rhinorrhea), periorbital bruising, anosmia (loss of smell), and headache. Some patients may also experience visual disturbances or neurological symptoms if associated brain injury occurs.

CT findings typically reveal linear or comminuted fractures along the ethmoid roof, pneumocephalus (air within the cranial cavity), and sinus opacification. High-resolution CT imaging of the skull base is the gold standard for diagnosis.

Treatment options depend on the severity of the fracture and the presence of CSF leak. Minor leaks may resolve with conservative management such as bed rest and head elevation, while persistent leaks or large defects often require surgical repair, commonly via endoscopic endonasal approaches.

Traumatic cribriform plate fracture: a detailed guide with symptoms, diagnosis, differential diagnosis, and operative techniques.

24/10/2025

✨ Natural-Looking Female Rhinoplasty ✨
Our goal in rhinoplasty is always to enhance—not change—your natural beauty. This patient wanted a softer, more harmonious profile while preserving her individual facial character. Through careful analysis and precise surgical planning, a balanced, natural, and feminine result was achieved.

https://www.ent-istanbul.com/2018/04/natural-rhinoplasty-in-istanbul-turkey.html

24/10/2025

✨ Natural-Looking Female Rhinoplasty ✨
Our goal in rhinoplasty is always to enhance—not change—your natural beauty. This patient wanted a softer, more harmonious profile while preserving her individual facial character. Through careful analysis and precise surgical planning, a balanced, natural, and feminine result was achieved.

https://www.ent-istanbul.com/2018/04/natural-rhinoplasty-in-istanbul-turkey.html