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Empty Nose syndrome is a rare condition of the nose where people feel obstructed yet have wide open breathing passages. There is typically some dryness or crusting and there may be pain. The key symptom is the sensation of congestion. This condition is thought to develop in patients that have had most or all of their turbinates removed. Some clinicians doubt that the condition exists.
Symptoms for empty nose syndrome include a sense that they can’t breathe out the nose. Sometimes there is dryness, crusting, pain and secondarily, anxiety of depression. On examination of a patient with empty nose syndrome with a scope or a CT scan, most or all of the turbinates will be gone. Airflow measurements of the nose of patients with this conditions show no obstruction and large airflows through the nose. There is no specific test or scan to diagnose this syndrome. A test, which is not universally agreed upon, is called a “cotton test.” Moist cotton is placed in the nose where the turbinates were, and with this syndrome, the patient will breathe better.
For empty nose syndrome, the underlying cause is theorized to be a malfunction of the nerve endings in the nose. Persons who have no turbinates, have large volumes of air that is cold, dry and unclean and this air it thought to cause problems with nerves in the mucous membranes. Nerves in the nose could also have been damaged directly during the removal of the turbinates. There is no microscopic proof of the above theories or the cause of empty nose syndrome. Again, some doctors doubt that the condition occurs at all.
Treatment of Empty Nose syndrome usually involves humidifiers and lubricants. If there is an infection, this is treated. If there is crusting, first irrigation, and then nasal hygiene helps. If there is anxiety or depression, psychological counseling is appropriate. Surgical treatment for this condition usually involves implants or fillers to take up some of the space that the absent turbinates had. After implants or fillers, airflow is usually reduced, and the patient feels as if they are breathing better.
Prevention of empty nose syndrome is done by addressing the turbinates surgically in a conservative manner. Turbinate reduction is a procedure that is performed often. It is important that it is not over-done.
