Intranasal trigeminal training in empty nose syndrome: A pilot study on 14 patients

Bon, Serge-Daniel Le; Horoi, Mihaéla; Bon, Olivier Le; Hassid, Sergio

doi:10.1111/coa.13483

Cited by 6 publications

(5 citation statements)

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“…Surgical reconstruction decreased the width of the nasal airway and improved the symptoms 23 . However, the neurosensory abnormality might not completely recover with surgery alone, and some patients may suffer from residual symptoms 28 . Thus, the importance of continued psychologic evaluation cannot be overemphasized both in pre‐operative stratification of patients and post‐operative identification of patients with residual disease.…”

Section: Discussionmentioning

confidence: 99%

Impact of Psychologic Burden on Surgical Outcome in Empty Nose Syndrome

et al. 2020

The Laryngoscope

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Objectives /Hypothesis Empty nose syndrome (ENS) is a complicated condition currently thought to be caused by excessive surgical resection of turbinate tissue. Patients with ENS experienced significant psychological symptoms, such as depression and anxiety. This study aimed to evaluate the impact of the psychological burden on the surgical outcome of ENS. Study Design Prospective case series in a tertiary medical center. Methods Patients with ENS were prospectively recruited between 2015 and 2018. Validated instruments including the Sinonasal Outcome Test‐25 (SNOT‐25), Beck Depression Inventory‐II (BDI‐II), and Beck Anxiety Inventory (BAI) were used to evaluate patients with ENS prior to and 3, 6, and 12 months after nasal reconstruction surgery with submucosal Medpor implantation. Results A total of 54 ENS patients were enrolled during the study period. All three evaluations revealed significant improvement, and symptoms stabilized 3 months after surgery. Six months post‐operatively, SNOT‐25 scores were significantly associated with the pre‐operative BDI‐II and BAI scores (β = 0.64 and 0.87; P = .006 and <.001, respectively). Multivariate regression model revealed that only BAI scores were significantly associated with the six‐month post‐operative SNOT‐25 scores (adjusted β = 0.49, P = .036). Moreover, Spearman's correlation found close relationships between the post‐operative SNOT‐25 and the post‐operative BDI‐II and BAI scores (rs = 0.751 and 0.884, both P < .001). Conclusions Psychological evaluation can help predict surgical outcomes and identify patients with residual disease. These findings emphasize the importance of screening for psychological symptoms and structuring care by including psychological therapy in addition to surgery. Level of Evidence 4. Laryngoscope, 131:E694–E701, 2021

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Section: Discussionmentioning

confidence: 99%

Impact of Psychologic Burden on Surgical Outcome in Empty Nose Syndrome

et al. 2020

The Laryngoscope

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“…Trigeminal nerve training has been shown to be effective, increasing trigeminal sensitivity along with increased subjective measures of nasal patency. 5,10 Limitations to this pilot study include its small and narrow sample size. Two subjects did not complete all visits in the study due to loss to follow-up and hypersensitivity to oxymetazoline.…”

Section: Discussionmentioning

confidence: 99%

“…There is a possible use of trigeminal stimulants as treatment in patients with intranasal trigeminal dysfunction. Trigeminal nerve training has been shown to be effective, increasing trigeminal sensitivity along with increased subjective measures of nasal patency 5,10 …”

Section: Discussionmentioning

confidence: 99%

“…3 Eucalyptol is used to both activate and train the trigeminal system. 4,5 MADomizer spray bottles (Teleglex) were used to administer 2 sprays of intranasal agents to each nostril. 6 Subjects were administered intranasal agents randomly in a complete crossover design over a period of at least 5 consecutive days.…”

Section: Methodsmentioning

confidence: 99%

“…Eucalyptol is an active component of Vicks VapoRub at 1.2% concentration 3 . Eucalyptol is used to both activate and train the trigeminal system 4,5 . MADomizer spray bottles (Teleglex) were used to administer 2 sprays of intranasal agents to each nostril 6 .…”

Section: Methodsmentioning

confidence: 99%

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Role of trigeminal sensation in patients without nasal obstruction: A pilot study

Durrant

Salvador

Chen

et al. 2023

Int Forum Allergy Rhinol

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A Systematic Review and Meta‐Analysis of Management Options for Empty Nose Syndrome: A Proposed Management Algorithm

Hussain,

Hayat,

Almhanedi

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveEmpty nose syndrome (ENS) is an acquired condition characterized by paradoxical nasal obstruction and sensation of nasal dryness often accompanied by psychological disorders such as depression or anxiety, typically occurring after the loss of inferior turbinate tissue or volume in the setting of prior sinonasal surgery. This review aims to identify and evaluate the reported management options.Data SourcesPubMed, Scopus, and Web of Science.Review MethodsThe terms “empty nose syndrome” OR “atrophic rhinitis” were used in a systematic search of original articles since the year 1990, yielding 1432 individual studies. These were screened on the Covidence platform for inclusion if any intervention was reported for the treatment of ENS. A pooled analysis of standardized mean differences (SMDs) combined with a random effects model was employed to report outcomes in Empty Nose 6‐Item Questionnaire (ENS6Q), Sino‐Nasal Outcome Test (SNOT), anxiety, and depression scores.ResultsA total of 35 articles were included, comprising 957 individual ENS patients. Surgical interventions mostly in the form of meatus augmentation implants accounted for 26 out of the 36 articles. The remaining ten articles included medical and psychological management options. SMD in SNOT, ENS6Q, anxiety, and depression scores were reported and demonstrated statistically significant improvements in follow‐up periods of up to 1 year. All articles reported favorable outcomes following their chosen interventions.ConclusionThere is a paucity of evidence on the management of ENS and an absence of randomized controlled trials. Surgical intervention appears to be the current mainstay of treatment, but there is a potential role for psychological and medical management.

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Intranasal trigeminal training in empty nose syndrome: A pilot study on 14 patients

Cited by 6 publications

References 10 publications

Impact of Psychologic Burden on Surgical Outcome in Empty Nose Syndrome

Impact of Psychologic Burden on Surgical Outcome in Empty Nose Syndrome

Role of trigeminal sensation in patients without nasal obstruction: A pilot study

A Systematic Review and Meta‐Analysis of Management Options for Empty Nose Syndrome: A Proposed Management Algorithm

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