Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Nitric Oxide. 2019 Nov 1;92:55-59. doi: 10.1016/j.niox.2019.07.005. Epub 2019 Aug 10.
Although cases of empty nose syndrome (ENS) are not very common, the suffering that ENS causes patient is immense and could be very difficult to imagine. Nasal nitric oxide (nNO) is an airway disease biomarker, and its levels increase after endoscopic sinus surgery. The trend of nNO levels in ENS before and after surgical treatment remains unknown. This study aimed to evaluate the role of nNO in ENS.
Patients with ENS who received surgical implantation and with chronic hypertrophic rhinitis (CHR) who underwent turbinoplasty and completed at least 1 year of follow-up were prospectively enrolled. nNO measurements and subjective assessments [SinoNasal Outcome Test (SNOT)-22, Beck Depression Inventory (BDI)-II, and Beck Anxiety Inventory (BAI)] were performed preoperatively and at 3, 6, and 12 months postoperatively.
We enrolled 19 ENS and 12 CHR patients. nNO levels were significantly lower in the ENS than in the CHR patients before surgical treatment (p < 0.001). nNO levels in the ENS patients significantly increased 3 months after implantation and remained plateaued (p = 0.015). BDI-II and BAI scores significantly improved after surgical treatment for the ENS patients but not for the CHR patients; changes in nNO levels correlated well with improvements in BDI-II and BAI scores (p = 0.025 and 0.035, respectively).
nNO significantly increased at third month after surgical treatment and remained plateaued in ENS patients. This increase correlated with improvements in BDI-II and BAI scores. Therefore, nNO may be important in assessing the psychiatric status of empty nose syndrome.
尽管空鼻综合征（ENS）的病例并不常见，但 ENS 给患者带来的痛苦是巨大的，可能难以想象。鼻一氧化氮（nNO）是一种气道疾病生物标志物，其水平在内窥镜鼻窦手术后会升高。ENS 患者手术前后 nNO 水平的变化趋势尚不清楚。本研究旨在评估 nNO 在 ENS 中的作用。
前瞻性纳入接受手术植入治疗的 ENS 患者和接受鼻甲成形术并完成至少 1 年随访的慢性肥厚性鼻炎（CHR）患者。在术前和术后 3、6 和 12 个月进行 nNO 测量和主观评估[鼻-鼻窦结局测试 22 项（SNOT-22）、贝克抑郁量表第二版（BDI-II）和贝克焦虑量表（BAI）]。
我们纳入了 19 例 ENS 和 12 例 CHR 患者。ENS 患者的 nNO 水平在手术治疗前明显低于 CHR 患者（p<0.001）。ENS 患者植入后 3 个月 nNO 水平显著升高并保持稳定（p=0.015）。ENS 患者手术治疗后 BDI-II 和 BAI 评分显著改善，但 CHR 患者无此变化；nNO 水平的变化与 BDI-II 和 BAI 评分的改善密切相关（分别为 p=0.025 和 0.035）。
ENS 患者在手术后第 3 个月 nNO 水平显著升高并保持稳定。这种增加与 BDI-II 和 BAI 评分的改善相关。因此，nNO 可能对评估空鼻综合征的精神状态很重要。
