Surgical treatment for empty nose syndrome

Objectives: To detail empty nose syndrome (ENS), an iatrogenic disorder characterized by a patent airway but a subjective sense of poor nasal breathing, and to explore repair options for patients with ENS. Design: A case series of 8 patients with ENS detailing symptoms before and after submucosal implantation of acellular dermis. Setting: Academic medical center. Patients: Subjects who were evaluated for abnormal nasal breathing and determined to have ENS. Patients were diagnosed as having ENS if they described characteristic symptoms, had evidence of prior nasal turbinate surgery, and their symptoms improved after they underwent a cotton test. Intervention: Acellular dermis was implanted submucosally to simulate missing turbinate tissue. Main Outcome Measures: Symptoms and symptom scores for the 20-item Sino-Nasal Outcome Test completed before and after the implantation were gathered. Results: A statistically significant improvement in symptom scores for the Sino-Nasal Outcome Test was noted (P <=.02). Conclusions: Careful assessment allows reconstructive surgery through submucosal implantation of acellular dermis. Symptoms of patients with ENS can improve with surgical therapy.