3.11.11  Discussion

Performing inferior turbinectomy as part of FESS is a somewhat controversial treatment of nasal obstruction or snoring. Most patients experience improved nasal breathing and some have resolution of anosmia. However, when extensive turbinectomy is combined with resection of other nasal and paranasal structures, empty nose syndrome­ is a potential complication (Fig. 3.36). This is an uncommon iatrogenic condition that results from inadequate nasal tissue and presents with persistent symptoms due to increased laminar airflow. Nevertheless, patients experience symptoms due to loss of normal turbulent flow through the nasal cavity and the lack of the ability to humidify air.

Fig. 3.36  Empty nose syndrome. The patient presents with persistent sensation of nasal obstruction following extensive FESS. Coronal CT image shows the results of septoplasty and extensive resection of the bilateral middle and inferior turbinates, with only a residual portion of the left inferior turbinate. There is right maxillary sinus mucosal thickening