Treatment Outcomes of the Inferior Meatus Augmentation Procedure with Autologous Costal Cartilage for Empty Nose Syndrome.

Abstract

Objective: Empty nose syndrome (ENS) is a rare postoperative complication arising from turbinate surgery. Here, we report our clinical experience and comprehensive analysis of the inferior meatus augmentation procedure with autologous costal cartilage (IMAP-ACC) for ENS.

Methods: We conducted a retrospective review of medical records of patients diagnosed with ENS and underwent IMAP-ACC at a tertiary referral center between November 2015 and November 2023. Symptom improvement was assessed by the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) score before and after the IMAP. Additionally, perioperative complications and revision surgery cases were investigated.

Results: Out of the 32 patients that underwent IMAP-ACC, the clinical analysis included 20 patients (16 males, 4 females) with a mean age of 39.1 ± 11.5 years and mean follow-up of 61.2 ± 28.8 months. The mean ENS6Q score improved significantly from 17.5 ± 5.3 preoperatively to 9.1 ± 6.0 at the last follow-up (p<0.001). In the subgroup analysis of 16 patients whose early follow-up data were available, significant improvements were observed in the ENS6Q scores at both the early (7.8 ± 5.7) and long-term follow-up (8.6 ± 6.5) compared to the preoperative value (18.2 ± 5.6). Among 32 patients, nasal obstruction was the most common perioperative complication (34.4%), necessitating reoperation in four patients (12.5%). Most complications were managed well with a conservative approach.

Conclusion: IMAP-ACC demonstrated its role as a valuable treatment option for patients with ENS, showing sustained effectiveness over a long-term follow-up period.