ArticleInternational forum of allergy & rhinology2021
Inferior meatus augmentation procedure (IMAP) normalizes nasal airflow patterns in empty nose syndrome patients via computational fluid dynamics (CFD) modeling.
Article in International forum of allergy & rhinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Evidence-based approaches for Empty Nose Syndrome management: a systematic review highlighting current treatments and future directions.Frontiers in bioengineering and biotechnology · 2026Pooled it
- Airflow Characteristics of Empty Nose Syndrome: Insights From Patient-Specific Computational Modeling of Airflow Distribution Patterns and Nasal Air-Conditioning.Laryngoscope investigative otolaryngology · 2026Article
- Cluster Analysis of Patients With Empty Nose Syndrome and Its Relation to Surgical Outcome.The Laryngoscope · 2026Article
- Does Total Inferior and Middle Turbinectomy Always Lead to Empty Nose Syndrome?Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Empty Nose Syndrome Treated With Inferior Turbinate Augmentation Using Homologous Costal Cartilage.Plastic and reconstructive surgery. Global open · 2026Article
- From Dry Cavities to Healing Pathways: Innovations in Managing Empty Nose Syndrome.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2025Article
- Does Total Turbinectomy Always Lead to Empty Nose Syndrome? A Computational Virtual Surgery Study.The Laryngoscope · 2025Article
- Surgical and Regenerative Treatment Options for Empty Nose Syndrome: A Systematic Review.Clinical and experimental otorhinolaryngology · 2024Article
- Functional Exercise Capacity and Perceived Exertion in Patients with Empty Nose Syndrome.Diagnostics (Basel, Switzerland) · 2024Article
- Identifying Residual Psychological Symptoms after Nasal Reconstruction Surgery in Patients with Empty Nose Syndrome.Journal of clinical medicine · 2023Article
- Utility of Serum Interleukine-6 Level in Empty Nose Syndrome.International journal of medical sciences · 2023Article
- Clinical perspectives on nasopharyngeal morphology in humans.Anatomical record (Hoboken, N.J. : 2007) · 2022Article
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9 authors at 2 institutions in 1 country.
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Abstract
backgroundEmpty nose syndrome (ENS) is a controversial upper airway disorder most commonly associated with tissue loss from the inferior turbinates. The inferior meatus augmentation procedure (IMAP) has been shown to effectively reduce ENS symptoms in a durable manner, but the precise mechanisms that may govern this symptomatic improvement remain unknown.
methodsFive patients with ENS who underwent bilateral IMAP via submucosal costal cartilage implant were assessed. Pre-implant and 6 months post-implant computed tomography (CT) imaging for each ENS patient was analyzed in a blinded fashion using computational fluid dynamics (CFD) modeling to investigate intrapatient changes in airflow parameters.
resultsFollowing surgery, ENS patients have significantly improved symptoms as indexed by Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) scoring (pre-implant: 14.00 ± 4.06 [mean ± standard deviation]; 95% confidence interval [CI], 10.44 to 17.56; post-implant: 4.8 ± 2.77; 95% CI, 2.37 to 7.23; Cohen's d = 2.64; p = 0.02). Using CFD, a significant shift in nasal airflow patterns was observed, where airflow deviates away from the middle meatus upon hitting the implant (pre-implant: 67.13% ± 11.14%; 95% CI, 60.22% to 74.04%; post-implant: 46.18% ± 12.81%; 95% CI, 38.23% to 54.12%; d = 1.74; p < 0.05) toward the inferior meatus (pre-implant: 30.55% ± 11.29%; 95% CI, 23.55% to 37.55%; post-implant: 42.59% ± 9.60%; 95% CI, 36.63 to 48.54%; d = 1.14; p < 0.05). No significant changes were found in nasal resistance (pre-implant: 0.102 ± 0.015; 95% CI, 0.092 to 0.112 Pa*s/mL; post-implant: 0.105 ± 0.041; 95% CI, 0.081 to 0.130 Pa*s/mL). In addition, the improvement of ENS6Q scoring significantly correlated with percent reduction in aberrant airflow through the middle meatus (R
conclusionThis study supports our prior working hypothesis that disordered vectors of nasal airflow congregate in the middle meatus contribute to ENS symptoms, not nasal resistance. Moreover, these data illuminate a paradoxical, but consistent, restoration of nasal airflow to the inferior meatus following the replacement of turbinate tissue volume in the inferior meatus via IMAP surgery, potentially due to the Coandă effect.
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