Allergy, Rhinology, and Immunology

Long-Term Outcomes of Inferior Meatus Augmentation Procedure to Treat Empty Nose Syndrome

Sachi S. Dholakia BS

orcid.org/0000-0002-4484-5123

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Angela Yang BS,

Angela Yang BS

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Dayoung Kim BA,

Dayoung Kim BA

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Nicole A. Borchard BA,

Nicole A. Borchard BA

orcid.org/0000-0002-4383-1619

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Michael T. Chang MD,

Michael T. Chang MD

orcid.org/0000-0001-9519-5880

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Ashoke Khanwalkar MD,

Ashoke Khanwalkar MD

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Matt Lechner MD, PhD,

Matt Lechner MD, PhD

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Jayakar V. Nayak MD, PhD,

Corresponding Author

Jayakar V. Nayak MD, PhD

[email protected]

Department of Otolaryngology - Head and Neck Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, U.S.A.

Send correspondence to Jayakar V. Nayak, MD, PhD, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94304. E-mail: [email protected]

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Sachi S. Dholakia BS,

Sachi S. Dholakia BS

orcid.org/0000-0002-4484-5123

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Angela Yang BS,

Angela Yang BS

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

Search for more papers by this author

Dayoung Kim BA,

Dayoung Kim BA

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

Search for more papers by this author

Nicole A. Borchard BA,

Nicole A. Borchard BA

orcid.org/0000-0002-4383-1619

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Michael T. Chang MD,

Michael T. Chang MD

orcid.org/0000-0001-9519-5880

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Ashoke Khanwalkar MD,

Ashoke Khanwalkar MD

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Matt Lechner MD, PhD,

Matt Lechner MD, PhD

Division of Rhinology, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Jayakar V. Nayak MD, PhD,

Corresponding Author

Jayakar V. Nayak MD, PhD

[email protected]

Department of Otolaryngology - Head and Neck Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, U.S.A.

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First published: 15 May 2021

https://doi.org/10.1002/lary.29593

Citations: 15

The abstract corresponding to this manuscript was selected for a podium presentation at the Triological Society Virtual Meeting at COSM April 9th, 2021.

Editor's Note: This manuscript was accepted for publication on April 20, 2021.

The authors have no funding, financial relationships, or conflicts of interest to disclose relevant to this work.

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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

Supporting Information

BIBLIOGRAPHY

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Citing Literature

Volume131, Issue11

November 2021

Pages E2736-E2741

Long-Term Outcomes of Inferior Meatus Augmentation Procedure to Treat Empty Nose Syndrome

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Information

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Long-Term Outcomes of Inferior Meatus Augmentation Procedure to Treat Empty Nose Syndrome

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Related

Information