EpistemisEmpty nose syndrome
Specialty: Otolaryngology.
Why it occurs
- Previous surgery for excessive or total resection of the inferior turbinates (total turbinectomy)
- Primary atrophic rhinitis (Ozena disease) associated with colonization by Klebsiella ozaenae
- Chronic and uncontrolled abuse of topical nasal decongestants that induces severe atrophy of the nasal mucosa
- Severe nasoseptal trauma with significant loss of functional mucosal tissue
Initial workup
Rigid or flexible nasofibrolaryngoscopy (revealing abnormally wide nasal cavities, absence of inferior turbinates, and mucosal dryness with crusts), rhinomanometry to evaluate airflows, and sinus CT documenting bone and mucosal loss of the turbinates.
red flags
Presence of persistent fetid nasal crusts that are difficult to remove, constant facial pain with neuropathic characteristics, dyspnea or a disabling feeling of suffocation despite an anatomically patent airway, suicidal ideation or severe depressive symptoms associated with respiratory dysfunction.
Standard management
- Abundant daily nasal washes with isotonic saline solution enriched with glycerin or moisturizing oils — master formulas to lubricate the mucosa
- Nasal ointments with vitamin A and E to promote superficial tissue regeneration
- Topical antibiotics such as mupirocin nasal ointment if there is persistent bacterial colonization and foul-smelling scabs
- Night ambient humidification using cold steam devices in the bedroom.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Otolaryngology
- Listed causes
- 4
- Treatment options
- 4