Introduction
Empty nose syndrome (ENS) is a medical condition that occurs when the turbinates (mucus-producing tissues) are cut out of the nose. This makes the nasal cavity too empty, wide, and dry, making the nose functioning difficult. Moreover, it can lead to breathing difficulties, headaches, nosebleeds, and nasal dryness.
What Is the History of Empty Nose Syndrome?
Empty nose syndrome is considered a controversial condition, and research is still going on for the causes and treatment of this condition. Only recently, in 2000, the ENT (ear, nose, and throat) specialists started addressing this condition as empty nose syndrome. The people affected with this condition experience various symptoms, such as always feeling their nose clogged despite the wide open nasal passage. In some cases, the condition can even lead to mental distress as the patient feels unable to breathe properly and lead to conditions like depression, anxiety, or even committing suicide.
What Are Turbinates?
The nose consists of various projections called turbinates. These are also called nasal concha or conchae (plural). The turbinates are responsible for various functions such as humidifying, warming, and filtering the air breathed in. The nasal turbinates consist of a thin bone surrounded by mucosal lining. Generally, there are three types of turbinates in the nose which include - superior (upper), middle, and inferior (lower) turbinates. However, there can be a fourth turbinate called the supreme turbinate, which is even higher than the superior turbinate.
These projections play various crucial roles which include -
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Turbinates consist of a large surface area, helping entrap the foreign material in the mucus. This prevents the harmful material from being inhaled and causing any infections.
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Turbinates keep the nasal passages moist and warm the inhaled air so that when it reaches the lungs, it can get humidified entirely and matches the body temperature same as the body temperature.
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The middle turbinate covers most sinuses (air-filled cavities) and prevents harmful particles from entering and causing infection.
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The turbinates provide information to the brain that air is traveling through the nose sufficiently to sustain life. Without sufficient mucosa in the nose to sense the air, a person feels choking instead of sufficient air intake.
What Are the Causes of Empty Nose Syndrome?
Empty nose syndrome (ENS) is rare and occurs in cases who have undergone turbinate surgery. It is still unknown why this condition occurs in people who have undergone nasal or turbinate surgery but not others. Research is still going on to find out how to prevent this condition. Given below are some of the causative factors related to this syndrome -
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Some studies have shown that disruption in the receptors on turbinates can be one of the reasons for empty nose syndrome. The receptors sense any change in pressure or temperature, and the surgery might interfere with these receptors. As a result, a person might lose the sense of nasal breathing.
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Changes in any pressure or temperature can be sensed by the body, even in the nasal cavity. Therefore empty nose syndrome is triggered by different levels of pressure or temperature inside the nose. This may result in difficulty in breathing.
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The nasal surgery can result in removing nasal mucus, which is important for regulating the beneficial bacteria in the nose. Therefore the reduction in the mucus could lead to an increased risk of colonization of harmful bacteria in the nose and worsening the symptoms of empty nose syndrome.
What Are the Symptoms of Empty Nose Syndrome?
The symptoms of empty nose syndrome can be different for each person. These can occur weeks, months, or even years after the nasal surgery. The symptoms related to ENS can cause difficulty performing daily tasks and can even lead to conditions like depression and anxiety. The majority of the people affected with empty nose syndrome feel that they are not able to breathe through their nose fully. Some of the other symptoms of ENS include -
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Frequent nosebleeds.
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A feeling that the air inhaled is too cold and dry.
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Nasal congestion, even though the nasal passage is clear.
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Dizziness.
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Reduced mucus production.
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Headaches.
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Severe nasal dryness.
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Pain.
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The sensation of drowning.
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Inflammation.
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Tiredness.
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Post-nasal drip.
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Problems with taste (ageusia) or smell (anosmia).
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Insomnia.
What Is the Diagnosis of Empty Nose Syndrome?
Empty nose syndrome is still not entirely understood in the medical field. Therefore there are no standard tests available to diagnose this syndrome. Most ENT specialists will ask for a CT (computed tomography) scan to check for any damage to the turbinates. Nasal passage airflow might also be tested. However, they will try to rule out other conditions resembling the symptoms of empty nose syndrome.
Endoscopy can also be done to see the inside of the nose with the help of a flexible tube with a tiny camera attached to the end. A cotton test can also be done to determine empty nose syndrome. In this test, saline-soaked cotton is placed within the nose. The results are considered positive if the patient experienced improved breathing, and this test helps in determining that further surgical procedures can help improve the symptoms. The doctor will try to evaluate the complete respiratory health of the patient before reaching the diagnosis of empty nose syndrome.
What Is the Treatment for Empty Nose Syndrome?
There is no specific treatment available for ENS, however, the primary goal of empty nose syndrome is to relieve the symptoms. Various treatment modalities can be used to manage the symptoms of ENS, including -
1. Home Remedies
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Drinking plenty of hot beverages.
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Using a humidifier.
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Using continuous positive airway pressure (CPAP) machine to help to breathe during sleep.
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Nasal and saline sprays can relieve symptoms like dryness, discomfort, and crusting.
2. Medicines
Certain medicines, such as estrogen and erectile dysfunction drugs, can enlarge the nasal tissue and help reduce symptoms.
3. Surgery
Surgery can also be done to increase the size of the remaining turbinate in the nose. This can be done by using implants or other materials. This can help balance the airflow in the nasal cavity and reduce the symptoms.
Conclusion
Empty nose syndrome can be uncomfortable and can interfere with the process of breathing. Moreover, the patient can experience various physical and mental challenges because of this condition. Currently, there is no cure for empty nose syndrome, and a patient can work with an ENT specialist to reduce the symptoms by going for regular checkups and avoiding complications.
