Eide Jacob G, Kuan Edward C, Adappa Nithin D, Chang Jeremy, Cho Do-Yeon, Garg Rohit, Govindaraj Satish, Grayson Jessica, Im Eunice, Keschner David, Kohanski Michael, Locke Tran, Palmer James N, Welch Kevin C, Woodworth Bradford A, Yoo Frederick, Craig John R
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health, Detroit, Michigan, USA.
Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, Irvine, CA, USA.
Laryngoscope. 2025 Jan;135(1):59-65. doi: 10.1002/lary.31694. Epub 2024 Aug 13.
Empty nose syndrome (ENS) is a poorly understood, debilitating condition affecting a minority of patients who underwent nasal airway surgery, most commonly following inferior turbinate surgery. Few publications have demonstrated middle turbinate resection (MTR) causing ENS, but MTR is still considered a potential cause of ENS. The Empty Nose Syndrome 6-item Questionnaire (ENS6Q) is validated for ENS diagnosis, with ENS6Q ≥ 11 considered highly suggestive of ENS. The purpose of this multicenter study was to determine the incidence of patients with ENS6Q ≥ 11 following subtotal MTR during endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP) by comparing preoperative and postoperative ENS6Q scores.
A multi-institutional prospective cohort study (8 US institutions) was conducted on patients who underwent bilateral subtotal MTR during ESS for CRSwNP. Preoperative and postoperative ENS6Q scores were compared after at least 12 months of postoperative follow-up.
Of 110 patients, mean age was 51.6 years and 59.1% were male. Mean follow-up was 14.5 ± 2.5 months (range 12.1-22.3 months). Mean preoperative and postoperative ENS6Q were 7.7 and 2.2, respectively, demonstrating a mean 5.5 point decrease postoperatively (p < 0.0001). At final follow-up, no patient had an ENS6Q ≥ 11. Of note, 20% of patients had preoperative ENS6Q scores ≥11, but all decreased to <11 postoperatively.
Based on prospective multicenter data over 1-2 years postoperatively, subtotal MTR for CRSwNP never led to ENS6Q scores ≥11, and patients experienced significant decreases in ENS6Q postoperatively. Subtotal MTR during ESS for CRSwNP was, therefore, unlikely to cause ENS even with long-term follow-up.
4 Laryngoscope, 135:59-65, 2025.
空鼻综合征（ENS）是一种了解较少的使人衰弱的疾病，影响少数接受过鼻气道手术的患者，最常见于下鼻甲手术后。很少有出版物表明中鼻甲切除术（MTR）会导致ENS，但MTR仍被认为是ENS的一个潜在原因。空鼻综合征6项问卷（ENS6Q）已被验证可用于ENS诊断，ENS6Q≥11被认为高度提示ENS。这项多中心研究的目的是通过比较术前和术后的ENS6Q评分，确定在慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）的鼻内镜鼻窦手术（ESS）中进行部分MTR后ENS6Q≥11的患者的发生率。
对在ESS期间因CRSwNP接受双侧部分MTR的患者进行了一项多机构前瞻性队列研究（美国8家机构）。在术后至少12个月的随访后比较术前和术后的ENS6Q评分。
110例患者中，平均年龄为51.6岁，59.1%为男性。平均随访时间为14.5±2.5个月（范围12.1 - 22.3个月）。术前和术后ENS6Q的平均值分别为7.7和2.2，术后平均下降5.�分（p < 0.0001）。在最终随访时，没有患者的ENS6Q≥11。值得注意的是，20%的患者术前ENS6Q评分≥11，但术后均降至<11。
基于术后1 - 2年的前瞻性多中心数据，CRSwNP的部分MTR从未导致ENS6Q评分≥11，且患者术后ENS6Q显著下降。因此，即使进行长期随访，ESS期间CRSwNP的部分MTR也不太可能导致ENS。
4 喉镜，135:59 - 65，2025年。
