Fu Chia-Hsiang, Chen Chien-Cheng, Huang Chi-Che, Chang Po-Hung, Chen Yi-Wei, Tang Ya-Cheng, Lee Ta-Jen
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.
Laryngoscope. 2024 Jul;134(7):3060-3066. doi: 10.1002/lary.31328. Epub 2024 Mar 23.
Empty nose syndrome (ENS) is an underdiagnosed but burdensome clinical condition. Studies that have addressed the impact of remnant inferior turbinate volume (ITV) on ENS are scarce. We aimed to evaluate the impact of ITV and phenotyping on the severity and presentation of ENS.
All the enrolled patients underwent the following subjective assessments: the ENS 6-Item Questionnaire (ENS6Q), Sino-Nasal Outcome Test-25 (SNOT-25), Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). The ITV was obtained from finely cut (1-mm-thick slices) sino-nasal computed tomography scan images and analyzed using ImageJ. The correlation between ITV, subjective measurements, and morphology of inferior turbinates was evaluated. ENS was categorized as torpedo type (balanced tissue volume) or pistol type (posterior dominance) based on the morphology.
Overall, 54 patients met the inclusion criteria. The ITV was positively correlated with the ENS6Q score and domain of ENS symptoms in SNOT-25. Neither BDI-II nor BAI scores had a significant correlation with ITV. Based on their morphological classification, the torpedo type exhibited diverse manifestations in the SNOT-25 analysis in response to changes in ITV, while the pistol type demonstrated an elevated rhinologic symptom burden and ENS-specific symptoms as their ITV increased. Nasal resistance did not correlate with the ITV in either type of ENS.
Symptoms were paradoxically worse in ENS patients with greater remnant ITV, and distinct morphological phenotypes in the nasal cavities may result in different presentations. Further investigation into the correlation between remnant inferior turbinates and nerve function is warranted.
3 Laryngoscope, 134:3060-3066, 2024.
空鼻综合征（ENS）是一种诊断不足但负担沉重的临床病症。探讨残余下鼻甲体积（ITV）对ENS影响的研究较少。我们旨在评估ITV和表型对ENS严重程度及表现的影响。
所有纳入患者均接受以下主观评估：空鼻综合征6项问卷（ENS6Q）、鼻-鼻窦结局测试-25（SNOT-25）、贝克抑郁量表第二版（BDI-II）和贝克焦虑量表（BAI）。ITV通过鼻窦计算机断层扫描图像的精细切割（1毫米厚切片）获得，并使用ImageJ进行分析。评估ITV、主观测量结果与下鼻甲形态之间的相关性。根据形态将ENS分为鱼雷型（组织体积平衡）或手枪型（后部占优势）。
总体而言，54例患者符合纳入标准。ITV与ENS6Q评分及SNOT-25中ENS症状领域呈正相关。BDI-II和BAI评分与ITV均无显著相关性。根据形态学分类分析，鱼雷型在SNOT-25分析中随着ITV变化表现出多样的症状，而手枪型随着ITV增加，鼻科症状负担和ENS特异性症状加重。两种类型的ENS中鼻阻力均与ITV无关。
ENS患者中残余ITV越大，症状反而越严重，鼻腔中不同的形态表型可能导致不同的症状表现。有必要进一步研究残余下鼻甲与神经功能之间的相关性。
3《喉镜》，2024年，第134卷，第3060 - 3066页
