Management of Postsurgical Empty Nose Syndrome - 03/10/19

Doi : 10.1016/j.fsc.2019.07.005

Jason Talmadge, MD ^a, Jayakar V. Nayak, MD, PhD ^b, William Yao, MD ^a, Martin J. Citardi, MD ^c,^⁎
^a Department of Otolaryngology, Medical College of Wisconsin, 3400 Market Lane, Kenosha, WI 53144, USA
^b Department of Otolaryngology, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA
^c Department of Otorrhinolaryngology, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street, MSB 5.036, Houston, TX 77030, USA

^∗Corresponding author.

Résumé

Empty nose syndrome (ENS) is a controversial condition associated with disruption of nasal airflow caused by excessive loss of turbinate tissue. ENS arises after total or near-total inferior turbinate resection. Patients present with intense fixation on the perception of nasal obstruction. Diagnostic tools to assess for empty nose syndrome include a validated patient questionnaire and the office cotton test. Treatment involves topical moisturization, behavioral/psychiatric assessment/treatment, and surgical reconstruction. Current data show promising long-term efficacy after surgical intervention. Postprocedural ENS is best prevented by minimizing inferior and middle turbinate tissue loss.

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Keywords : Empty nose syndrome, Atrophic rhinitis, Turbinate, Cotton test, ENS6Q, Nasal airway, Upper airway

Plan

Key points

Introduction

Pathophysiology of empty nose syndrome

Diagnosis of empty nose syndrome

Prevention of empty nose syndrome

Treatment of empty nose syndrome

Medical Therapy

Surgical Therapy

Summary

Disclosure Statement: M.J. Citardi serves as a consultant for Acclarent (Irvine, CA), Intersect ENT (Palo Alto, CA), Medical Metrics (Houston, TX), and Stryker (Kalamazoo, MI). W. Yao is a member of the Optinose (Yardley, PA) speaker’s bureau. J.V. Nayak is a consultant for Medtronic (Jacksonville, FL), Olympus America (Center Valley, PA), and Cook Medical (Bloomfield, IN). He is on the scientific advisory board of Hydravascular, Inc (Milpitas, CA).The rest of the authors have nothing to disclose.