Long‐Term Outcomes of Inferior Meatus Augmentation Procedure to Treat Empty Nose Syndrome. (15th May 2021)

• Record Type: Journal Article
• Authors: Dholakia, Sachi S.; Yang, Angela; Kim, Dayoung; Borchard, Nicole A.; Chang, Michael T.; Khanwalkar, Ashoke; Lechner, Matt; Nayak, Jayakar V.
• Is Part Of: Laryngoscope. Volume 131:Number 11(2021)
• Page Start: E2736
• Page End: E2741
• Publication Date: 2021-05-15
• Subjects: cadaveric rib cartilage -- cotton test -- empty nose syndrome -- empty nose syndrome 6‐item questionnaire -- inferior meatus augmentation -- implant -- upper airway; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.29593
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objectives/Hypothesis: We sought to report the long‐term, symptom‐focused, prospective outcomes in empty nose syndrome (ENS) patients after undergoing inferior meatus augmentation procedure (IMAP) through use of four validated questionnaires: Empty Nose Syndrome 6‐Item Questionnaire (ENS6Q), 22‐item Sino‐Nasal Outcome Test (SNOT‐22), Generalized Anxiety Disorder 7‐Item Scale (GAD‐7), and Patient Health Questionnaire‐9 (PHQ‐9). Study Design: Prospective case series. Methods: A single‐center prospective case series was performed for patients diagnosed with ENS who underwent IMAP between July 2017 and February 2020. Diagnosis of ENS was based on the following criteria: 1) reported discomfort with nasal breathing and/or paradoxical nasal obstruction after inferior turbinate reduction, 2) a positive ENS6Q score of at least 11, and 3) a positive cotton test. Questionnaire responses were recorded prior to surgery as well as 1, 3, 6, and 12 months postoperatively. Results: Seventeen eligible patients were included. Mean ENS6Q scores were significantly reduced at all postoperative time points ( p < .0001, p < .0001, p < .0001, p = .0003). Of the six ENS6Q subdomains, five (suffocation, dryness, sense of diminished airflow, nasal crusting, and nasal burning) were significantly reduced 1‐year postoperatively ( p < .0001, p = .0004, p = .0136, p = .0114, p = .0080, respectively). SNOT‐22 scores were significantly reduced at all time points ( p = .0021, p = .0227, p = .0004, and p = .0025). Of the SNOT‐22 subdomains, the sleep subdomain was significantly reduced 1‐year postoperatively ( p = .0432). Low baseline GAD‐7 and PHQ‐9 scores were recorded at 7 and 9.4, respectively, and although scores at all postoperative time points were reduced, there was no statistical significance. Conclusion: IMAP via implant of cadaveric rib cartilage provides significant, long‐term improvements in ENS‐specific and general sinonasal symptoms. Level of Evidence: 4 Laryngoscope, 131:E2736–E2741, 2021