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Pictured: Hobbit condom. Yup, it’s gonna get weird again.

You can pick your friends. You can pick your nose. But you can’t pick your friends nose.

Unless you practice Nasal Cranial Release.

There are so many pseudo-medicines, it is hard to keep track. New variations appear, new combinations of old SCAMs occur, old pseudo-medicines wax and wane, although no pseudo-medicine ever dies. Except phenology? Maybe? I find a few phrenology sites on the web, but I cannot tell if they are real or satire.

There is an ongoing discussion in my family as to the greatest band of all time. The Who is THE correct answer, but really, bands do not have to follow the Pauli exclusion principle. There can be multiple greatest bands of all time, all existing simultaneously at the same place. Except that The Who is a little bit more greater than the others. Yes. More greater.

The same concept applies to SCAMs. Whose goofiness reigns supreme? Homeopathy? Reiki? Epigenetic Birth Control? They are all equally goofy, each in their own special way.

In my feeds I saw the announcement that “Anderson Chiropractic Announces Nasal Cranial Release Therapy“. I had never heard of Nasal Cranial Release Therapy. It sounds bad, turning humans into a PEZ dispenser, popping off the skull by way of the nose, a particularly horrific form of rhinotillexomania. It’s not that goofy. But close.

Nasal Cranial Release appears to be the mutant offspring of chiropractic and craniosacral therapy and goes by a variety of other names including:

Endonasal Technique, Bilateral Nasal Specific Technique, Functional Cranial Release, and Neurocranial Release

Balloons, or hobbit condoms, I can’t tell from the photographs, are inserted in the nose and inflated to realign cranial bones. Really. Watch the video. Judging from the patient it is not a pleasant experience. And I always watch these videos with the eye of an infection control doctor. No gloves or hand hygiene to be seen and given the propensity for MRSA to be harbored in the nose it gives me the willies. The procedure appears to be booger compression, an intervention I suspect no one really needs. Compressing snot is unlikely to have any significant anatomic or physiologic effects.

The method is different than balloon sinuplasty where the sinuses are opened up by expanding a balloon in the sinus ostia. In contrast to Nasal Cranial Release the balloon is directed into place with an endoscope and look! They use local anesthesia and wear gloves in a procedure room. Watch the videos sequentially and compare and contrast real medicine with cargo cult medicine.

Nasal Cranial Release was developed in the 1930s by a chiropractor and naturopath in Portland Oregon to treat concussion and traumatic brain injury. Really. It gives me the heebie-jeebies to think of inflating a balloon in the nose after traumatic brain injury. The balloon should do nothing to normal skulls, but if there were an occult basilar skull fracture?

The information to support the practice is almost, but not quite, entirely unlike data. I found case report that after:

Chiropractic manipulation and soft tissue manipulation administered 2–6 times per month for approximately 1 yr had minimal long-term effect on the patient’s head pain.

Really? The patient returned 6 times a month for a year with no effect from the intervention? That’s salesmanship.

Then the patient had resolution of the headache after several months (!) of nasal realignment. The patient probably reporting improvement so they would never have to return for more treatments. It would appear to be the only way to escape the clutches of that particular chiropractor.

Even chiropractors admit that:

No articles appear available in the scientific literature that examine the efficacy of the nasal specific technique for treating any pathology. Searching for such literature uncovered one unpublished study by Nyiendo and Goldeen. Their study concluded that claims for improved vision and hearing following nasal specific treatment could neither be supported nor refuted. They did find, however, changes in craniofacial measurements that did not reach significance when compared to a control (sham-treated) group.

No known efficacy and no effect on the skull, yet like all pseudo-medicines, the ‘indications’ are broad. Mostly suggested for concussion and head trauma, it is also suggested for a variety of neurologic diseases and symptoms.

One chiropractic site even suggests it will prevent the need for braces. The mechanism?

the connective tissues that surround your brain and spinal cord called the Dura Mater are specifically released using endonasal balloon inflations.

And the nasal balloons:

Restore the brains ability to oxygenate itself through both improving air flow into higher area’s through the nasal passage

Which made me giggle as it seems to imply that oxygen gets to the brain directly across the base of the brain rather than from the arteries by way of the lung.

No surprise, the only reports on Pubmed I could find are complications: fracture and bleeding.

Chiropractors like to brag that their education is on par with MDs. Then they do bone-headed pseudo-science like this, actually thinking that by inflating a balloon in the nose they can place:

… the bones in better alignment allows for optimal blood flow to the brain and spinal cord and neuro-transmitter activity throughout the central nervous system.

After a shorter version of this essay a chiropractor commented

Please don’t generalize. Most chiropractors don’t do this ridiculous crap and we definitely do not learn this in chiropractic school.

As if correcting spinal subluxations, the raison d’être of chiropractic, is any less goofy. And maybe the other ridiculous crap in chiropractic school will be no longer be taught:

European Schools Sign Anti-Subluxation Position Statement

Six chiropractic schools signed a position statement that says:

The teaching of vertebral subluxation complex as a vitalistic construct that claims that it is the cause of disease is unsupported by evidence. Its inclusion in a modern chiropractic curriculum in anything other than an historical context is therefore inappropriate and unnecessary.

Which is similar to the General Chiropractic Council in the United Kingdom, which has a Guidance that says:

The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns.

They are referred to “Subluxation Deniers.” Like Vaccine and Global warming deniers, one of these is not like the others.

I wonder if all the ridiculous crap is removed from chiropractic practice, what will be left?

 

 

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He is a founder and  the President of the Society for Science-Based Medicine where he blogs under the name sbmsdictator. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His growing multi-media empire can be found at edgydoc.com.

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