Empty nose syndrome: A literature review

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Empty nose syndrome is a symptom complex disease that includes paradoxical nasal obstruction and that arises from total or partial turbinate resection. The pathogenesis of the disease is associated with mucosal deficit, altered nasal cavity aerodynamics, and impaired sensory innervation. The reduced shear stress of air stream gives rise to irritation of the sensory endings of the trigeminal nerve. TRPM8 cold thermoreceptors that transmit information to the respiratory center in the brain are one of the types of sensory endings. Both subjective (SNOT-25) and objective (rhinomanometry, acoustic rhinometry) measures are used as preoperative preparation and evaluation of surgical treatment. Therapy. Medical treatment for empty nose syndrome is to constantly moisten the nasal mucosa. Surgical treatments are based on the submucosal implantation of various materials to restore the architectonics of endonasal structures and to create a laminar air flow. The aim of surgery is to improve air conditioning and to eliminate the symptoms of nasal congestion, dryness, and crusting. The most common surgical technique is to narrow the nasal valve due to the submucosal implantation of materials into the nasal fundus, lateral wall, and septum. The analysis of the efficiency of these operations has low validity and is based on a patient's subjective sensations. Conclusion. Surgical treatments are unable to restore nerve endings n the nasal mucous membrane. Thus, full recovery is impossible today.

Keywords:

empty nose syndrome

secondary atrophic rhinitis

TRPM8 thermoreceptors

nasal aerodynamics

submucosal implantation

Authors:

Kosiakov S.Ia.

Kafedra otorinolaringologii Rossiĭskoĭ meditsinskoĭ akademii poslediplomnogo obrazovaniia, Moskva

Kirdeeva A.I.

Russian Medical Academy for Post-Graduate Education, Moscow, Russia, 125993

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