ENT Doctor in Istanbul

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

12/10/2025

Nasal Herpes Simplex Infection: A Rare Pathway From Skin Lesion to Brain Involvement



https://www.ent-istanbul.com/2025/10/nasal-herpes-simplex-brain-intracranial-infection.html

Did you know a simple cold sore on the nose can, in rare cases, spread to the brain? Nasal herpes simplex (HSV-1) infections are usually mild, but in exceptional situations, the virus can travel along nerve pathways, leading to serious complications like encephalitis or meningitis. Early recognition and prompt antiviral treatment are key to preventing severe outcomes.

28/09/2025

https://www.ent-istanbul.com/2025/06/nasal-hyperventilation-with-nasal-valve.html

27/09/2025

Airplane Ear - Eardrum Barotrauma During The Air Travel

https://www.ent-istanbul.com/2023/02/airplane-ear-eardrum-trauma-during-air-travel.html

Airplane ear, also known as eardrum barotrauma, occurs when rapid changes in cabin pressure during air travel cause discomfort, pain, or even temporary hearing loss. It happens because the Eustachian tube cannot equalize the pressure between the middle ear and the environment.

26/09/2025

https://www.ent-istanbul.com/2025/09/overimplantation-and-nasal-congestion.html

Discussion on graft size and placement in Empty Nose Syndrome implantation, focusing on surgical approaches and patient outcomes.

26/09/2025

Submucosal Temporalis Fascia Implantation (Inferior Meatus Augmentation Procedure (IMAP) - Nasal Floor Implantation and Lateral Nasal Wall Temporalis Fascia Implantation

https://www.ent-istanbul.com/2025/09/overimplantation-and-nasal-congestion.html
https://www.ent-istanbul.com/2021/10/nferior-meatus-augmentation.html

The image above shows an intranasal endoscopic examination of a patient who presented with complaints of a feeling of cold air, crusting, dryness, and bleeding within the nose after a previous rhinoplasty performed at a different clinic. The patient's left inferior turbinate was completely resected, and this area was significantly enlarged. A dry and red area is visible in the anterior portion of the middle turbinate due to rapid air exposure (green arrow). The nasal mucosa is unhealthy, bleeding, and crusty. The patient's left nasal cavity became abnormally wide. A temporalis fascia graft, taken from the temporal region on both sides, was placed submucosally in several layers to the left nasal floor (yellow arrow) and the lateral nasal wall (blue arrow). A silicone splint was removed after a week of use. Even after just one week, the nasal mucosa appeared healthier and pinker, the dry, reddened area in the middle turbinate mucosa had completely disappeared, and the nasal passage was narrowed.

15/09/2025

The Paradox Between Turbinate Volume and Complaint Severity in Patients with "Empty Nose Syndrome - ENS"

https://www.ent-istanbul.com/2025/09/the-paradox-between-turbinate-volume-empty-nose-ens.html

In some patients with Empty Nose Syndrome (ENS), turbinate volume may appear large, yet their symptoms are more severe. This paradox highlights that turbinate size alone does not determine nasal function. Mucosal health, airflow dynamics, and sensory feedback are equally important in understanding patient complaints.