Is a person in my scenario at greater risk for Empty Nose Syndrome?

My turbinates swell my nose shut when lying down and for large parts of the day when upright. There are times I can breath fine but the vast majority of the time breathing is restricted. No sleep apnea. I do not have allergies. My ENT has recommended a septoplasty and bilateral turbinectomy after a year of not responding to medical therapy. Am I at greater risk for ENS because I have brief moments of clarity? What would my nose feel like when swelling is down and turbinates have been reduced?

Doctor Answers 5


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ENS is uncommon but you are no more at risk than any other patient so long as you have a conservative turbinate reduction performed

Empty nose syndrome

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Empty nose syndrome rarely occurs today because the techniques to improve nasal breathing have improved. Turbinoplasty is more directed at reshaping and shrinking the bone and mucosa rather than excision. Best of luck with your nasal breathing.

Benjamin C. Paul, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

Empty Nose Syndrome

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Empty nose syndrome is quite rare and is generally related to over-resection of the inferior and/or middle turbinates.  When turbinate resection is indicated, it is usually performed very selectively because of the valuable role the turbinates play in the warming, and humidification of nasal airflow.  

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Is a person in my scenario at greater risk for Empty Nose Syndrome?

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Hello CharlesH85 - Thanks for your question. The classic ENS patient has a history of nasal steroid therapy and undergoes turbinate excision procedures. Modern turbinate surgery is so much more gentle that ENS is quite rare. If your surgeon is trained in advanced techniques for turbinate reduction (RF coblation, microshaver, etc.) your chances of ENS are minimal. As your nose opens up and the airflow increases, you may complain of cold headaches. I usually recommend the use of a warm mist humidifier in this case. My patients here in Denver, usually are recommended to use a cool mist humidifier on a regular basis because it is an alpine desert here. Over time the cold headaches subside.  If you have a fixed obstruction, then you don't typically have to wait a year for surgery. But you might have to if you live in Canada.  Good luck, Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Empty nose syndrome

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Thank you for your question.It is hard to determine if someone is going to develop empty nose syndrome. My best advice would be to schedule a consultation with a board certified plastic surgeon who specializes in nasal procedures so they can perform a nasal examination and discuss your concerns to be able to determine whether you are a good candidate for a septoplasty.  I would also recommend speaking with a psychologist about your concerns and see if they medically clear you for your surgery or believe it is something mentally/emotionally you need to work through or to have that support system post operatively if you are experiencing anxiety about your surgery.
Best of luck.
Sincerely, James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.