Can Someone Get ENS Just from Having a Rhinoplasty/septoplasty?

Question

I want to have a rhinoplasty and I have a slightly deviated septum too. But I don't want to go through with it I can end up with Empty Nose Syndrome. Is ENS only something that occurs with a turbinate reduction or can it occur even with a rhinopasty and septoplasty too?

David R. Stephens, MD · Answer

Hi Rayah. One of the most impressive areas of plastic surgery that I have seen in terms of growth of consistent diagnosis and treatment is in in the area of nasal surgery over the past 20 years. In my career we have seen the advancement of the open technique as a reliable and advanced procedure with the numerous ways the we can create a nice tip with less risk of revision procedures with this. this has led to improvements in the closed technique. I am grateful to those surgeons during my training who have contributed to making the procedure more systematic and predictable and have warned us of the pitfalls. What is most interesting, is that we are now doing more conservative and less destructive procedures with less risk of compromising function. There are less "done" looking noses out there.The septo-rhinoplasty and the management of the turbinates with more conservative techniques has little or no risk of the issue you bring up as a result of these advancements. You have very little to worry about here, particularly with no turbinate surgery. In experienced hands you have little to worry about with modern turbinate surgery,

Kenneth Hughes, MD · Answer

Empty nose syndrome should not occur even with turbinate management along with septoplasty and rhinoplasty. This is largely the result of paradigm changes in surgical technique that have evolved over the past several decades. This is largely of historical interest and should not occur on a primary nose. Kenneth Hughes, MD Los Angeles, CA

Ronald J. Edelson, MD · Answer

I remove turbinates commonly and have never had a patient with ENS.  The literature also says that this problem is quite rare.  I think it is very unlikely.

Tanveer Janjua, MD · Answer

Empty nose syndrome occurs with aggressive resection of turbinates. It is unlikely to occur with a regular septoplasty and rhinoplasty. Even if the turbinates are reduced in size with any of the available surgical methods, it will not cause ENS.

	Regards

	Dr. J

	Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Evan Ransom, MD, FACS · Answer

Empty Nose Syndrome (ENS) is a chronic condition where the internal nasal airflow and mucous production is very abnormal. This is generally characterized by chronic crusting, recurrent infection, and a sensation of abnormal airflow (even when there is plenty of space). It would be very rare for ENS to result from a primary septorhinoplasty. Generally this happens after overly agressive sinus surgery with turbinectomies (turbinate resection) or after multiple revision rhinoplasty procedures. I hope this helps! If you have more questions, please visit me in San Francisco.

Toby Mayer, MD · Answer

Rhinoplasty does not produce an empty nose syndrome. Over resection of the turbinates will produce this and does not occur with rhinoplasty and or septoplasty. See an experienced surgeon and u will not have to worry about this.

Jeffrey Zwiren, MD · Answer

Over resection of the turbinates can be a problem. This can cause a symptomatic rhinitis or dripping from the nose. When performing a turbinectomy or turbinate reduction I like to use cold coblation. This shrinks down the tissue and avoids the problem of over resection. Not all rhinoplasties require a turbinectomy. If you have a pure nasal airway obstruction problem this is best handled by an experienced ENT surgeon.

William Portuese, MD · Answer

Empty nose syndrome will not occur from a rhinoplasty or a septoplasty. EMS is caused from her over resection of the inferior or middle turbinates. Experienced rhinoplasty surgeons will not create an EMS scenario.

Michael Elam, MD (retired) · Answer

Dear Rayah7, Having a Rhinoplasty and Septoplasty or what as surgeons we call a Septorhinoplasty will not cause ENS. An over resection of the turbinates may cause this however in my over 30 years of experience I have never had this as a complication. Best regards, Michael V. Elam, M.D.

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