The Empty Nose Syndrome

Patients who have too much tissue removed from their nose at the time of surgery will sometimes develop an empty nose syndrome. They will have a variety of symptoms including the sensation of too much air flowing through the nose, halitosis, lack of mucus, bleeding, lack of sense of smell, dryness, crusting, inflammation, dizziness, etc. Many patients are bothered severely by this and often become extremely preoccupied with it.

They may also have atrophic rhinitis which means that the the cells in the lining of the nose don't function normally and so doesn't produce enough mucus. Unfortunately as a person ages, the lining of the nose normally ages, so that many years after surgery, a patient may develop the empty nose syndrom due to development of atrophic rhinitis.

There is much debate about the cause of the empty nose syndrome. Most people think that the cause is due to having too much turbinate tissue removed at the time of surgery, but not everyone who has turbinate tissue removed will develop the empty nose syndrome.

Patients who have both the inferior turbinate and middle turbinate removed are more likely to develop the empty nose syndrome. Obviously they will have more tissue removed than someone who only had part of the middle turbinate removed.

In some cases it may be necessary to remove part of the middle turbinate in order to do surgery. Please note that the turbinate removal referred to here is not the same as the somnoplasty technique which is discussed below.

Adjunctive techniques such as irrigation, mucus thinners, and nasal sprays may be somewhat helpful. Increasing the humidity in the winter may also be helpful. The Mayo clinic uses glycerine solution topically to the lining of the nose. They will also use mineral oil flavored with rose geranium oil for bad breath. Some patients are helped by having cotton plugs or silicone plugs fashioned to reduce some of the nasal airflow. Unfortunately once the tissue is removed it cannot be replaced, although there are currently experimental technique to create artificial turbinates.