Back متلازمة الأنف الفارغة Arabic Empty Nose Syndrome German Síndrome de la nariz vacía Spanish Syndrome du nez vide French סינדרום האף הריק HE Tómnefsheilkenni Icelandic Sindrome del naso vuoto Italian 빈 코 증후군 Korean Empty nose syndrome Dutch Síndrome do nariz vazio Portuguese

Empty nose syndrome

Empty Nose Syndrome
Other namesSecondary atrophic rhinitis
Altered nasal anatomy after bilateral subtotal inferior turbinectomy, the removal of most turbinate tissue.
SpecialtyOtolaryngology
SymptomsSensation of nasal suffocation despite clear airway
ComplicationsHyperventilation syndrome, depression, anxiety, fatigue
Usual onsetFollowing surgery or injury to the nasal interior
Differential diagnosisAnxiety, Hyperventilation
TreatmentArtificial nasal moisture, experimental corrective surgeries
FrequencyUnknown, but considered rare in medical literature

Empty nose syndrome (ENS) is a clinical syndrome, the hallmark symptom of which is a sensation of suffocation despite a clear airway. This syndrome is often referred to as a form of secondary atrophic rhinitis. ENS is a potential complication of nasal turbinate surgery or injury.[1][2] Patients have usually undergone a turbinectomy (removal or reduction of structures inside the nose called turbinates) or other surgical procedures that injure the nasal turbinates.

ENS patients may experience a range of symptoms. Commonly reported are feelings of nasal obstruction, nasal dryness and crusting, and a sensation of being unable to breathe.[3]

The overall incidence of ENS is unknown due to the small body of epidemiological study and the lack of a dedicated International Classification of Diseases (ICD-10) code, which would allow incidence reporting of the syndrome. In a 2019 study in the Facial Plastic Surgery Clinics of North America journal, study lead Jason Talmadge posited that "many cases likely go unrecognized or underdiagnosed, and therefore unreported."[4]

The condition is caused by injury to the nasal turbinates, particularly with nasal procedures. This includes both minor procedures as well as total turbinate resection. It is usually observed in patients with unobstructed nasal passages following surgical intervention who report sensations of suffocation or obstruction following recovery. Early literature attributed ENS to complete turbinate resection, but later research demonstrated the syndrome in patients who had undergone a range of procedures that involved nasal turbinates.[3][5][6][7][8] Even unilateral, partial reduction of the inferior turbinate may lead to ENS.[9]

The syndrome's existence as a distinct medical condition is controversial, with adoption by a growing body of ear, nose and throat (ENT) practitioners and plastic surgeons. ENS is not fully understood and practitioner knowledge about altered nasal breathing in turbinate surgeries varies. Understanding why some patients exhibit ENS symptoms while others do not and incorrectly attributing symptoms to psychological causes such as anxiety are common reasons ENS patients do not receive care.[3] ENS as a distinct condition is subject to debate, including whether it should be considered solely rhinologic or whether it may have neurological or psychosomatic aspects. Growing awareness of the syndrome and an increasing body of research has led to more acceptance by ENT practitioners.[3][5][10][11][12][13][excessive citations]

  1. ^ Cite error: The named reference :0 was invoked but never defined (see the help page).
  2. ^ deShazo, Richard D; Stringer, Scott P (February 2011). "Atrophic rhinosinusitis: progress toward explanation of an unsolved medical mystery". Current Opinion in Allergy & Clinical Immunology. 11 (1): 1–7. doi:10.1097/ACI.0b013e328342333e. ISSN 1528-4050. PMID 21157302. S2CID 27205163.
  3. ^ a b c d Kuan, EC; Suh, JD; Wang, MB (2015). "Empty nose syndrome". Curr Allergy Asthma Rep. 15 (1): 493. doi:10.1007/s11882-014-0493-x. PMID 25430954. S2CID 43309184.
  4. ^ Talmadge, Jason; Nayak, Jayakar V.; Yao, William; Citardi, Martin J. (November 2019). "Management of Postsurgical Empty Nose Syndrome". Facial Plastic Surgery Clinics of North America. 27 (4): 465–475. doi:10.1016/j.fsc.2019.07.005. ISSN 1558-1926. PMID 31587766. S2CID 203850289.
  5. ^ a b Sozansky J, Houser SM (Jan 2015). "Pathophysiology of empty nose syndrome". Laryngoscope. 125 (1): 70–4. doi:10.1002/lary.24813. PMID 24978195. S2CID 29735233.
  6. ^ Houser, Steven M. (2007-09-01). "Surgical Treatment for Empty Nose Syndrome". Archives of Otolaryngology–Head & Neck Surgery. 133 (9): 858–863. doi:10.1001/archotol.133.9.858. ISSN 0886-4470. PMID 17875850. Although total turbinate excision is most frequently the cause of ENS, lesser procedures (eg, submucosal cautery, submucosal resection, cryosurgery) to reduce the turbinates may cause problems as well if performed in an overly aggressive manner.
  7. ^ "FFAAIR | Syndrome du Nez Vide (SNV)". www.ffaair.org (in French). Retrieved 2019-09-11. suite d'interventions endonasales diverses (turbinectomie, turbinoplastie, cautérisation)
  8. ^ Saafan. "Empty nose syndrome: etiopathogenesis and management". www.ejo.eg.net. Retrieved 2019-09-11. ENS is a complication of middle and/or inferior turbinate surgery, most frequently total turbinate excision, but also with minor procedures such as submucosal cautery, submucosal resection, laser therapy, and cryosurgery if performed in an aggressive manner
  9. ^ Talmadge, Jason; Nayak, Jayakar V.; Yao, William; Citardi, Martin J. (November 2019). "Management of Postsurgical Empty Nose Syndrome". Facial Plastic Surgery Clinics of North America. 27 (4): 465–475. doi:10.1016/j.fsc.2019.07.005.
  10. ^ Leong SC (Jul 2015). "The clinical efficacy of surgical interventions for empty nose syndrome: A systematic review". Laryngoscope. 125 (7): 1557–62. doi:10.1002/lary.25170. PMID 25647010. S2CID 206202553.
  11. ^ Coste, A; Dessi, P; Serrano, E (2012). "Empty nose syndrome". Eur Ann Otorhinolaryngol Head Neck Dis. 129 (2): 93–7. doi:10.1016/j.anorl.2012.02.001. PMID 22513047.
  12. ^ Hildenbrand, T; Weber, RK; Brehmer, D (2011). "Rhinitis sicca, dry nose and atrophic rhinitis: a review of the literature". Eur Arch Otorhinolaryngol. 268 (1): 17–26. doi:10.1007/s00405-010-1391-z. PMID 20878413. S2CID 34729974.
  13. ^ Payne SC (2009). "Empty nose syndrome: what are we really talking about?". Otolaryngol. Clin. North Am. 42 (2): 331–7, ix–x. doi:10.1016/j.otc.2009.02.002. PMID 19328896.
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