Huang Chien-Chia, Wu Pei-Wen, Huang Chi-Che, Chang Po-Hung, Fu Chia-Hsiang, Lee Ta-Jen
Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taoyuan City 333, Taiwan.
School of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.
J Clin Med. 2023 Mar 31;12(7):2635. doi: 10.3390/jcm12072635.
Empty nose syndrome (ENS) is a syndrome of paradoxical nasal obstruction that is thought to be mostly caused by inappropriate turbinate procedures. This study aimed to investigate depression- and anxiety-associated psychological symptoms in patients with ENS before and after surgical reconstruction, and to compare them with those of control subjects.
Patients with ENS were prospectively enrolled. The Sino-Nasal Outcome Test-25 (SNOT-25), Empty Nose Syndrome 6-item questionnaire (ENS6Q), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) were used to evaluate the participants before and after reconstruction surgery with submucosal Medpor implantation (Stryker, Kalamazoo, MI), as well as control subjects at enrollment.
Forty patients with ENS and forty age- and sex-matched controls were recruited. Patients with ENS experienced significant improvement in SNOT-25, ENS6Q, BDI-II, and BAI scores after surgery, but all were significantly greater than those in the control group. Nine patients with ENS (22.5%) had postoperative residual psychological symptoms. Preoperative BDI-II and BAI scores were significant predictors of postoperative residual psychological symptoms. The optimal cut-off value was BDI-II > 28.5 (sensitivity, 77.8%; specificity, 77.4%) in receiver operating characteristic curve analysis.
The nasal and psychological evaluations in patients with ENS significantly improved after nasal reconstruction surgery, but both were significantly greater than those in the control group. Identifying individuals who may experience postoperative residual symptoms and providing a multimodal approach, including surgical reconstruction and psychiatric treatment, are suggested.
空鼻综合征（ENS）是一种矛盾性鼻阻塞综合征，被认为主要由不适当的鼻甲手术引起。本研究旨在调查手术重建前后ENS患者与抑郁和焦虑相关的心理症状，并将其与对照组受试者的症状进行比较。
前瞻性纳入ENS患者。使用鼻-鼻窦结局测试-25（SNOT-25）、空鼻综合征6项问卷（ENS6Q）、贝克抑郁量表第二版（BDI-II）和贝克焦虑量表（BAI）对接受Medpor黏膜下植入术（史赛克公司，密歇根州卡拉马祖）重建手术前后的参与者以及入组时的对照组受试者进行评估。
招募了40例ENS患者和40例年龄及性别匹配的对照者。ENS患者术后SNOT-25、ENS6Q、BDI-II和BAI评分均有显著改善，但均显著高于对照组。9例ENS患者（22.5%）术后有残留心理症状。术前BDI-II和BAI评分是术后残留心理症状的显著预测因素。在受试者工作特征曲线分析中，最佳截断值为BDI-II>28.5（敏感性为77.8%；特异性为77.4%）。
ENS患者经鼻重建手术后，鼻腔和心理评估均有显著改善，但均显著高于对照组。建议识别可能出现术后残留症状的个体，并提供包括手术重建和心理治疗在内的多模式方法。
