Empty Nose Syndrome

Empty Nose Syndrome (ENS) is the term that is used to describe a nose that has been essentially crippled and deformed by excessive surgical intervention typically from a rhinoplasty or revision rhinoplasty to alter the turbinates inside. This condition can also be caused by recurrent, untreated infection and inflammation of the turbinates in the nose, but due to advances in modern medicine, this cause is extremely rare. ENS usually produces two symptoms – chronic nasal dryness and paradoxical obstruction – the feeling of not being able to breathe through the nose, although there is nothing obstructing you from doing so. Both of these can greatly impact a person’s quality of life.

Turbinates are three projections within the nose – inferior, middle and superior. The turbinates’ function is to help trap foreign matter and bacteria as it enters the nose by using the mucous the nose produces. They warm and moisten the air that we inhale and they also provide surface area/airway resistance, which tells the brain the body is getting enough air to sustain life. These turbinates are also responsible for making you turn in your sleep, if you sleep on your side. The lower turbinates will with fluid and press against the septum, which signals your body to turn on its other side.

When the turbinates are compromised during surgeries to correct other nasal and sinus issues, they can eventually be eroded away. The same surgical procedure that’s supposed to be alleviating another issue is actually creating more serious issues that will have to be addressed later, as the turbinates lose their ability to function and the body’s breathing process is interrupted.

Treating ENS can be approached with surgical and non-surgical methods. The non-surgical treatment options focus on improving the health of the remaining nasal mucosa by keeping it moist and free of infection with irrigation methods like saline drops and sprays. Surgical procedures for correcting ENS are meant to narrow the enlarged nasal cavity by bulking up the turbinates with implant materials or by creating neo-turbinates through implants placed in the nose. These implant materials may be autografts
from the patient in the form of bone or tissue from another location in their body, a foreign substance like Teflon or gortex or allografts such as AlloDerm®, which are bone and tissue materials from other donors.

Empty nose syndrome can severely impact a person’s quality of life. If you think you are suffering from this condition and would like to find out what your treatment options are, schedule a consult with a physician that specializes in otolaryngology for the best results. Dr. Azizzadeh is a expert in empty nose syndrome procedures and treatment.