Man Smelling Roses - and Everything Else - After Tandem Surgeries by Sibling Doctors

John Coyle is back on his job as a part-time parking enforcement officer for the city of Royal Oak after surgeries to end chronic sinus infections and reconstruct his nose were performed at Beaumont Royal Oak Hospital. (Photo submitted)

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A Royal Oak man is about to breathe in the smells of spring for the first time in nearly 40 years.

John Coyle has sibling surgeons Dr. Matthew Rontal and Dr. Daniel Rontal, both ear, nose and throat surgeons, to thank for his newly enhanced olfactory senses.

Coyle, 60, a part-time parking enforcement officer for the city of Royal Oak, went to the Beaumont Health System’s Royal Oak Hospital emergency room with a gushing nosebleed last fall, the hospital said in a news release.

Nosebleeds weren’t anything new, but Coyle had always been able to control them with pressure. He had also given up years ago smelling the aromas others raved about.

“I was always the last to smell anything,” he said.

Dr. Matthew Rontal, who was on call in the emergency room the day Coyle rushed in with his profuse nosebleed, was able to bring it under control.

The larger problem, however, was a complete collapse of the support structure of the nose, the result of a birth defect and two failed surgeries more than 35 years ago.

The combination of these circumstances had caused the underlying nasal tissue to deteriorate; Coyle was unable to breathe through his nostrils and severe nose bleeds and sinus infections had become a way of life.

Chronic inflammation and recurrent infection caused constant swelling of the sinus lining tissue and thickening of the bony walls of the sinuses. Typically the thickness of an eggshell, these walls had grown to half an inch thick in some places.

Before a successful reconstruction could take place, the Rontal brothers collaborated on the best way to address Coyle’s chronic sinusitis.

That first three-hour surgery took place Oct. 14.

Working within an extremely tight space – eight milimeters from front-to-back and 13 milimeters from side-to-side, the equivalent of a marble – Daniel Rontal had another challenge.

He had to navigate the tight space without the benefit of anatomical markers, which had been destroyed during the two failed surgeries in the 1980s.

“I used special tracking equipment to guide me as I drilled through the excess bone, which was delicately located between the eye socket and the brain,” he said.

Afterward, Coyle was able to breathe through his nose for the first time in decades.

“I breathe easier now when doing cardio exercises. My sense of taste has also improved and food is more satisfying,” a benefit Coyle said, that has led to eating less, not more.

Research shows that chronic sinus infection sufferers experience lower quality of life than those suffering from chronic obstruction pulmonary disease, COPD, and lower back pain, Daniel Rontal said.

With the ability to breathe and smell restored, the stage was set for a Jan. 20 tandem surgery by the Rontal brothers: a rib cartilage harvest and nose reconstruction.

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Even the cartilage harvest portion of the procedure was not without risk.

“Of course most rhinoplasties are not so extreme,” Matthew Rontal said in the news release. “But in this case, the patient needed reconstruction of the support structure for the nose extending from the bridge to the nasal tip and from the tip down to the upper lip. Rib cartilage provides that support since it is firm and straight and can be carved into multiple grafts.”

In the end, everything came together as planned and Coyle was back on the job in just two weeks, a new man – his nose restored from its former collapsed and contracted shape.

Daniel Rontal said very few hospitals in the country would have been able to offer the combined technical expertise to tackle what he said was “a fairly challenging condition.”

Matthew Rontal said it was personally rewarding to play a role in restoring Coyle’s quality of life.

“John is the nicest guy in the world and the nose is the central feature of the face,” he said. “To take a guy with such a severe deformity and chronic infection and discomfort – and really help him – that’s a pretty rewarding thing to do. To be able to accomplish that with my brother was especially fun.”

Coyle said his only regret is having waited so long to seek relief.

“It’s pretty exciting to have a normal looking nose after all of these years,” he said.