Computed Tomographic Evaluations in Patients with Empty Nose Syndrome.

Area of Science:

• Otolaryngology
• Radiology
• Rhinology

Background:

• Empty nose syndrome (ENS) is a challenging condition characterized by paradoxical nasal obstruction despite adequate nasal airway.
• Surgical interventions aim to improve nasal airflow and patient quality of life, but their impact on sinus inflammation and optimal anatomical parameters requires further investigation.

Purpose of the Study:

• To evaluate computed tomography (CT) findings in patients with ENS.
• To assess the effect of reconstruction surgery on sinus inflammation using CT.
• To identify the optimal anterior airspace diameter post-surgery and its correlation with patient-reported outcomes.

Main Methods:

• Retrospective case series analysis of patients with ENS and available perioperative CT scans.
• Modified Lund-Mackay (mLM) CT scores were used to quantify sinus inflammation.
• Anterior airspace diameter was measured on coronal CT images.

Main Results:

• No significant changes in mean total mLM CT scores or subsite scores were observed post-surgery.
• Anterior airspace diameter was significantly associated with Empty Nose Syndrome 6-item Questionnaire (ENS6Q) and Sino-nasal Outcome Test-25 (SNOT-25) scores.
• Sleep, psychological, and ENS symptom domains also showed significant associations with anterior airspace diameter.

Conclusions:

• Reconstruction surgery for ENS does not significantly alter sinus inflammation as assessed by CT.
• The anterior airspace diameter is a crucial anatomical parameter that correlates with symptom severity and quality of life in ENS patients.