Surgical outcome for empty nose syndrome: Impact of implantation site

Lee, Ta‐Jen; Fu, Chia‐Hsiang; Wu, Chieh‐Liang; Lee, Yi-Chan; Huang, Chi‐Che; Chang, Pi-Yueh; Chen, Yiwei; Tseng, Hsiao‐Jung

doi:10.1002/lary.26769

Cited by 35 publications

(37 citation statements)

References 14 publications

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“…The inferior turbinate is essential in providing resistance to airflow and regulating airflow distribution. It has been documented that patients with ENS showed clinical improvements by receiving endonasal submucosal implantation 23, 24 .…”

Section: Discussionmentioning

confidence: 99%

Investigation of the abnormal nasal aerodynamics and trigeminal functions among empty nose syndrome patients

Farag

Maza

et al. 2017

Int Forum Allergy Rhinol

112

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Section: Discussionmentioning

confidence: 99%

Investigation of the abnormal nasal aerodynamics and trigeminal functions among empty nose syndrome patients

Farag

Maza

et al. 2017

Int Forum Allergy Rhinol

112

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“…Medpor implantation reconstructed the nasal airway, decreased the width of the passage and volume of the direct cool airflow, and improved the symptoms (13,14,20,21) . Hence, the neurosensory abnormality due to improper mucosal healing would not be altered by surgery.…”

Section: Clinical Characteristics Of the Study Populationmentioning

confidence: 99%

“…Patients were surgically treated by the same surgeon (Ta-Jen Lee) with endoscopic-assisted submucosal Medpor implanta-tion, as described previously (10,13,14) . In brief, under local anaes-…”

Section: Surgical Interventionmentioning

confidence: 99%

“…Our previous study (10) using validated instruments including the Beck Depression Inventory-II (BDI-II) (11) and Beck Anxiety Inventory (BAI) (12) found that depression and anxiety are common among ENS patients and could be effectively improved after surgical treatment. Furthermore, submucosal implantation with porous high density polyethylene (Medpor; Porex Surgical, Inc.) provided better outcomes when implanted in the lateral nasal wall than in the inferior nasal wall (13) . Given this association, it is likely that impairments in each of the QOL domains within the SNOT-25 would differentially affect the severity of anxiety and depression.…”

Section: Introductionmentioning

confidence: 99%

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What drives depression in empty nose syndrome? A Sinonasal Outcome Test-25 subdomain analysis

Wu²,

et al. 2019

Rhin

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Background: Empty nose syndrome (ENS) is a debilitating disorder characterised by paradoxical nasal obstruction after excessive surgical excision of nasal tissues. ENS negatively impacts the quality of life (QOL) and psychological status of patients. This study aimed to determine the associations among disease-specific QOL impairments and the severity of anxiety and depression before and after surgery in ENS patients. Methods: A total of 68 ENS patients were prospectively recruited and underwent submucosal Medpor implantation. QOL impairments and the severity of anxiety and depression were evaluated using the Sinonasal Outcome Test-25 (SNOT-25), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) 1 day before and 6 months after surgery. Results: The BDI-II and BAI scores were significantly associated with the total score and ear/facial symptoms, psychological dysfunction, sleep dysfunction, and empty nose symptoms domains of the SNOT-25. Surgery improved disease-specific and psychological symptoms. Post-operative changes in the BDI-II score were correlated with changes in the total score and sleep dysfunction and empty nose symptoms domains of the SNOT-25. A SNOT-25 total score of > 60, sleep dysfunction domain score of > 18, and empty nose symptoms domain score of > 14 were good predictors of moderate-to-severe depression. Conclusions: ENS symptoms are associated with psychological burden and could be good predictors of moderate-to-severe depression. Targeted symptom improvement could reduce the psychological burden.

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“…Due to the severity of these symptoms, ENS patients often struggle with psychosocial issues and can present with comorbid psychiatric problems such as anxiety and depression that can significantly reduce the effectiveness of conventional treatment . Treatments such as submucosal implants have been shown to restore the spatial contouring of the nasal cavity and improve both rhinologic and psychological symptoms in ENS patients . However, little is known about the underlying pathophysiology that could drive the successful procedural outcome and how developing such an understanding could be translated into optimizing future procedures.…”

mentioning

confidence: 99%

The cotton test redistributes nasal airflow in patients with empty nose syndrome

Malik

Thamboo

Dholakia

et al. 2020

Int Forum Allergy Rhinol

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Background: Empty nose syndrome (ENS) remains a controversial disease primarily associated with inferior turbinate tissue loss. Co on placement into the inferior meatus o en alleviates ENS symptoms within minutes, but the physiologic explanation for this phenomenon is unknown. Computational fluid dynamics (CFD) was employed to evaluate the mechanisms of altered nasal airflow conferred by co on testing. Methods:Six ENS patients (12 sides) with pre-existing sinus computed tomography (CT) imaging were enrolled a er marked symptomatic improvement (decrease in score on the Empty Nose Syndrome 6-Item Questionnaire [ENS6Q] of >7 points) with office-based co on testing. The fashioned co on plug was labeled in situ with iohexol contrast spray, and sinus CT was immediately obtained to detect co on contouring in the inferior meatus. CT imaging from pre-and post-co on placement was analyzed using comparative CFD techniques. Results:A er co on placement, significant symptomatic improvement and reduced ENS6Q scores (16.8 ± 4.1 to 3.1 ± 2.4; p < 0.001) were recorded. Using CFD, co on placement produced an expected 21% increase in upper airway resistance (p < 0.05). However, a significant shi in the nasal airflow distribution was also detected, with a transition of airflow vectors away from a middle meatus jetstream (−41%; p < 0.002). Conclusion:Objective CFD assessment confirmed that the co on test not only increases nasal resistance, but also restores airflow distribution to the inferior meatus in symptomatic ENS patients. These results highlight the potential efficacy of co on test in ENS patients and further bolster the utility of this tool in identifying appropriate candidates for the inferior meatus augmentation procedure. C 2020 ARS-AAOA, LLC.

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Surgical outcome for empty nose syndrome: Impact of implantation site

Abstract: 4. Laryngoscope, 128:554-559, 2018.

Cited by 35 publications

References 14 publications

Investigation of the abnormal nasal aerodynamics and trigeminal functions among empty nose syndrome patients

Investigation of the abnormal nasal aerodynamics and trigeminal functions among empty nose syndrome patients

What drives depression in empty nose syndrome? A Sinonasal Outcome Test-25 subdomain analysis

The cotton test redistributes nasal airflow in patients with empty nose syndrome

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