Objectives: The objective of this study was to assess the clinical efficacy and safety of topical nitroglycerin ointment in patients diagnosed with empty nose syndrome (ENS).
Methods: ENS was diagnosed based on clinical history, nasal endoscopic findings, a positive cotton test, and an Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) score of ≥ 11. Patients who met the inclusion criteria were instructed to apply a topical nitroglycerin ointment (Rectogesic, glyceryl trinitrate 0.2%) three times daily. The mean age was 42.09 years, with a male-to-female ratio of 3:1. Pre- and posttreatment ENS6Q scores were compared, and subjective symptom improvement was analyzed.
Results: The total ENS6Q score showed a significant improvement, dropping from 17.32 ± 4.34 to 12.52 ± 5.21 (p < 0.001). All six ENS6Q items showed significant improvements, with the greatest reduction observed in nasal dryness (4.16 to 2.86, p < 0.001). Sixteen patients (36.4%) showed moderate improvement (ΔENS6Q = 3 to 6). Fifteen patients (34.1%) showed marked improvement (ΔENS6Q > 6), exceeding the minimal clinically important difference. Subjective symptom improvement was reported by 27 patients (61.4%), who demonstrated significantly greater ENS6Q improvement than those without symptom improvement (ΔENS6Q 7.22 ± 4.99 vs. 0.94 ± 2.41, p < 0.001). Eleven patients (25.0%) reported adverse effects; mild headache was the most common symptom (n = 6, 54.5% of adverse effects). The presence of adverse effects did not have a significant impact on treatment duration.
Conclusions: Topical nitroglycerin showed promising preliminary results and may represent a potential conservative treatment option for ENS, an uncommon yet serious complication arising after turbinate volume reduction surgery.
Keywords: empty nose syndrome; intranasal; nitroglycerin; symptom assessment; turbinate surgery.
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