Management of Postsurgical Empty Nose Syndrome

Facial Plast Surg Clin North Am. 2019 Nov;27(4):465-475. doi: 10.1016/j.fsc.2019.07.005.


Empty nose syndrome (ENS) is a controversial condition associated with disruption of nasal airflow caused by excessive loss of turbinate tissue. ENS arises after total or near-total inferior turbinate resection. Patients present with intense fixation on the perception of nasal obstruction. Diagnostic tools to assess for empty nose syndrome include a validated patient questionnaire and the office cotton test. Treatment involves topical moisturization, behavioral/psychiatric assessment/treatment, and surgical reconstruction. Current data show promising long-term efficacy after surgical intervention. Postprocedural ENS is best prevented by minimizing inferior and middle turbinate tissue loss.

Keywords: Atrophic rhinitis; Cotton test; ENS6Q; Empty nose syndrome; Nasal airway; Turbinate; Upper airway.

Publication types

  • Review

MeSH terms

  • Acellular Dermis
  • Biocompatible Materials / therapeutic use
  • Cartilage / transplantation
  • Humans
  • Iatrogenic Disease
  • Nose Deformities, Acquired / diagnosis*
  • Nose Deformities, Acquired / etiology
  • Nose Deformities, Acquired / surgery*
  • Nose Deformities, Acquired / therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Reoperation / methods
  • Rhinoplasty / adverse effects*
  • Rhinoplasty / methods*
  • Syndrome
  • Turbinates / surgery*


  • Biocompatible Materials