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Empty Nose Syndrome Pathophysiology: A Systematic Review.

Dichapong Kanjanawasee1,2,3, Raewyn G Campbell2,4,5, Janet Rimmer5,6,7

  • 1Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|October 19, 2021
PubMed
Summary

The pathophysiology of empty nose syndrome (ENS) is complex, with findings suggesting a link to mental health disorders and altered trigeminal-thermoreceptor responses, though airflow changes and surgical causes remain unclear.

Keywords:
empty nose syndromenasal perceptionneurogenic dysfunctionpsychogenic comorbidity

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Area of Science:

  • Otolaryngology
  • Rhinology
  • Pathophysiology

Background:

  • Empty Nose Syndrome (ENS) pathophysiology remains poorly understood despite extensive research.
  • A systematic review is crucial to consolidate current knowledge on ENS mechanisms.

Purpose of the Study:

  • To systematically review and synthesize existing literature on the pathophysiology of Empty Nose Syndrome (ENS).

Main Methods:

  • Systematic review of MEDLINE and Embase databases.
  • Inclusion of studies providing original data on ENS pathophysiology.
  • Screening of 2476 studies, with 19 meeting inclusion criteria (13 case-control, 6 cross-sectional).

Main Results:

  • ENS patients exhibit high symptom severity, with over 50% reporting anxiety and depression.
  • Impaired menthol detection and lower nasal nitric oxide levels are observed in ENS.
  • While structural and airflow parameters may be similar post-surgery, computational fluid dynamics reveal differences; turbinate histopathology shows tissue remodeling.

Conclusions:

  • High comorbidity of mental health disorders in ENS patients is evident.
  • Potential abnormal trigeminal-thermoreceptor response identified.
  • The role of altered airflow and surgical causation in ENS requires further investigation.