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Facial Plast Surg Clin North Am. 2019 Nov;27(4):465-475. doi: 10.1016/j.fsc.2019.07.005.

Management of Postsurgical Empty Nose Syndrome.

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Department of Otolaryngology, Medical College of Wisconsin, 3400 Market Lane, Kenosha, WI 53144, USA.
Department of Otolaryngology, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA.
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. Electronic address:


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.


Atrophic rhinitis; Cotton test; ENS6Q; Empty nose syndrome; Nasal airway; Turbinate; Upper airway


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