Chhabra and Houser listed the clinical findings in a patient with the Empty Nose Syndrome (ENS). The authors are from Case Western Reserve University and MetraHealth Medical Center in Cleveland.


Clinical findings:

(1) loss of turbinate tissue, usually with a history of nasal surgery with resection of one or more turbinates

(2) paradoxical airway obstruction with complaints consistent with airway obstruction but no evidence of obstruction on exam

(3) dyspnea

(4) dryness of nasal and pharyngeal mucosa with or without crusting

(5) hyposmia

(6) depression (especially in patients without a history of nasal surgery)

(7) dry and pale nasal mucosa with or without squamous metaplasia


The patient will have a positive "cotton test": A piece of cotton moistened with isotonic saline and placed to prevent apposition of the medial and lateral walls of the nasal cavity relieves the symptoms.


Relief of symptoms by suitable placement of a submucosal implant supports the diagnosis.


To read more or access our algorithms and calculators, please log in or register.