Middle turbinate resection unlikely to develop empty nose syndrome in first postoperative year
Empty nose syndrome (ENS) is characterized by nasal dryness, crusting, and paradoxical nasal obstruction most commonly after inferior turbinate resection. ENS has also been reported to occur after middle turbinate resection (MTR), and concern for causing ENS is a possible reason surgeons preserve the MT during endoscopic sinus surgery (ESS).
However, a recent research reveals that patients who underwent bilateral subtotal MTR during ESS were unlikely to develop ENS by at least 1 year postoperatively, based on patients rarely experiencing ENS6Q scores ≥ 11 or persistent nasal crusting.
The study is published in the American Journal of Otolaryngology--Head and Neck Medicine and Surgery.
Richard H. Law and associates from the Department of Otolaryngology Head and Neck Surgery, Henry Ford Hospital, Detroit, USA carried out a prospective case series of 95 consecutive patients that underwent bilateral subtotal MTR during ESS with either Draf IIB or Draf III frontal sinusotomies, for chronic rhinosinusitis with or without nasal polyps, and frontal sinus inverted papillomas.
Demographic data and postoperative Empty Nose Syndrome 6-item Questionnaire (ENS6Q) scores were obtained. Nasal crusting was also documented on last postoperative nasal endoscopy.
The results of the study revealed that-
a. Pathologies included chronic rhinosinusitis with nasal polyps (69), without nasal polyps (12), and inverted papillomas (14).
b. Fifty-six patients underwent subtotal MTRs during ESS with Draf IIB, and 39 with Draf III.
c. Mean follow-up was 19.4 months (range 12-49).
d. Mean postoperative ENS6Q score was 2.1.
e. Only 2.1% had ENS6Q scores ≥ 11, and 6.3% had nasal crusting at last follow-up.
f. None of the patients with ENS6Q scores ≥ 11 had nasal crusting at last follow-up.
g. There were no significant differences in outcomes between ages, genders, surgery types, or pathologies.
Therefore, the authors concluded that "patients who underwent bilateral subtotal middle turbinate resection (MTR) during endoscopic sinus surgery (ESS) were unlikely to develop Empty nose syndrome (ENS) by at least 1 year postoperatively."