ArticleThe Laryngoscope2025
Does Total Turbinectomy Always Lead to Empty Nose Syndrome? A Computational Virtual Surgery Study.
Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- 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
- Reply to: Correspondence for "Developing a Virtual Endoscopic Surgery Planning System to Optimize Surgical Outcomes".International forum of allergy & rhinology · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
introductionComputational fluid dynamic (CFD) modeling has previously indicated that distorted nasal airflow patterns may contribute to empty nose syndrome (ENS); however, no data show that aggressive turbinate surgery always leads to ENS. We aim to use virtual surgery planning (VSP) to investigate how a total inferior turbinectomy affects airflow parameters compared with ENS patients.
methodsWe retrospectively recruited six nasal obstruction patients who underwent turbinate reduction surgery. We virtually performed total inferior turbinectomy on these patients to compare CFD modeling results to patients' actual surgical outcomes and to that of a previously collected ENS patient cohort (n = 27).
resultsPatients' actual surgery outcomes were excellent, with Nasal-Obstruction Symptom Evaluation (NOSE) score (pre: 72.5 ± 13.2 vs post-surgery: 10.8 ± 9.8, p < 0.001) and unilateral visual analog scale (VAS) scores of nasal obstruction (pre: 6 ± 2.56 vs post-surgery: 1.2 ± 1, p < 0.001) improved and was statistically significant. The virtual turbinectomy does not create the same distorted nasal airflow patterns as seen in ENS patients, with no statistically significant difference in nasal resistance as compared with post-actual surgery (virtual turbinectomy: 0.10 ± 0.03 Pa/mL*s; actual surgery: 0.12 ± 0.04 Pa/mL*s; ENS: 0.11 ± 0.04, p > 0.05) nor in regional wall shear force distribution, an important indicator of air/mucosa stimulation (inferior turbinate WSF%: virtual 47.3% ± 11.3% vs actual 51.5% ± 15.1%, p > 0.05); however, both are statistically significant higher than that of ENS patients (WSF: 32.2% ± 12.5%, p < 0.001), despite ENS cohort having wider inferior airway cross-sectional area (CSA) than actual surgeries.
conclusionEmpty nose syndrome is likely a multifactorial disease process that cannot be solely attributed to aggressive turbinate reduction surgery. LEVEL OF EVIDENCE: 3 Laryngoscope, 135:562-569, 2025.
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