The empty nose syndrome follows an operation of the turbinates of the nose (turbinectomy) and includes several nasal symptoms including the feeling of not feeling the air entering the nose during breathing.
the empty nose syndrome or SNV is a complication of turbinate reduction surgery for nasal obstruction. This disease suffers from lack of knowledge and recognition while the impact on the quality of life of the patients concerned is major. In December 2022, the High Authority for Health (HAS) recommends “favor the surgical procedures with the least risk of occurrence of the syndromenot to consider turbinectomy only as a last resort, in case of persistent and disabling nasal obstruction in failure of medical treatment and in preserving the cones as much as possible” in one communicated published on December 15. HAS also recalls that empty nose syndrome is always the consequence of an invasive surgical procedure on the lower or even middle turbinates of the nose. In April, the High Authority of Health had already included in its work program the drafting of a recommendation for good practice on the subject of the prevention, diagnosis and treatment of empty nose syndrome in the event of surgical intervention for nasal obstruction, at the request from the Empty Nose Syndrome France Association and the French Federation of Associations and Friends of the Sick, Insufficient or Respiratory Disabled.
Definition: what is empty nose syndrome?
Empty nose syndrome refers to a collection of nasal symptoms occurring in one variable time frame (days to years) after spinal surgery (total or partial removal of the turbinates of the nose). This operation is carried out as a last resort in the event of nasal obstruction, chronic allergic rhinitis. The total ablation of the turbinates (total turbineectomy) is generally avoided apart from exceptional cases (cancer). On the other hand, the partial ablation limited to a third of its volume or, a cauterization of the turbinates can be practiced without danger.
What causes empty nose syndrome?
Empty nose syndrome is secondary to a procedure called turbinectomy which involves removing part of the inferior turbinate. “In the nose we have three turbinates: lower, middle and upper. They are like mucous sponges that serve to warm and moisten the air that one breathes through the nose. In other words, if you remove too much, the nose will become very dry and scabs will form, which will lead to a feeling of empty nose, that is to say that the feeling of the passage of air no longer exists “, explains Dr. Alain Bizon.
What are the symptoms of empty nose syndrome?
During an empty nose syndrome, the person no longer feels the air entering her nose when she breathes. Other symptoms include a significant dryness of the mucous membranes of the nose, nasal pain but also difficulty sleeping, fatigue, headaches, difficulty concentrating, mood disorders, the appearance of strong anxiety, even depression.
What are the risk factors for empty nose syndrome?
“There are no risk factors, it is a complication of the intervention which occurs in 2 to 3% of cases. This is the reason why turbinectomy is practiced less and less, in favor of turbinoplasty which consists of reducing the mucous membrane without touching the bone, indicates the cervico-facial surgeon. The result over time is less but you are exposed to far fewer complications “.
How to diagnose empty nose syndrome?
“The diagnosis is made examining the patient’s nose and according to his clinical picture: he had a stuffy nose, he was operated on and he no longer feels the passage of air. When we look inside, the nose is far too dry and far too broad compared to a normal nose “, continues the specialist.
How to treat empty nose syndrome?
You just have to wash your nose with seawater to remove all crusts and moisten the mucous membranes as much as possible but there is no miracle treatment.
What are the risks of complications from empty nose syndrome?
The numbers are from 1 to 3% complications, or even more for some professionals, which represents a fairly high percentage, all the more so since there is no reconstructive surgery possible. It is difficult to quantify the exact number of people affected due to the lack of specific studies. Patients with these complications feel mutilated of an important part of their body which according to them was functioning much better before the intervention.
Can empty nose syndrome be cured?
No, the empty nose syndrome does not heal. We can only improve the symptoms.
Thanks to Dr Alain Bizon, ENT doctor and cervico-facial surgeon at the University Hospital of Angers.