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ENS is a potential complication of nasal turbinate surgery or injury. [1] [2] Patients have usually undergone a turbinectomy (removal or reduction of structures inside the nose called turbinates) or other surgical procedures that injure the nasal turbinates. ENS patients may experience a range of symptoms.
A turbinectomy or turbinoplasty (preserving the mucosal layer) is a surgical procedure, that removes tissue, and sometimes bone, of the turbinates in the nasal passage, particularly the inferior nasal concha. The procedure is usually performed to relieve nasal obstructions. [1]
Nasal surgery is a specialty including the removal of nasal obstruction that cannot be achieved by medication and nasal reconstruction. Currently, it comprises four approaches, namely rhinoplasty, septoplasty, sinus surgery, and turbinoplasty, targeted at different sections of the nasal cavity in the order of their external to internal positions.
Inferior turbinate reduction is a surgery to reduce the size of the inferior turbinates. There are different techniques, including bipolar radiofrequency ablation (also known as somnoplasty), electrocautery, and use of cold steel instruments (eg, microdebrider). Inferior turbinectomy is a surgery to remove the inferior turbinates.
Atrophic rhinitis can also result from long-standing purulent sinusitis or radiotherapy of the nose, or as a complication of surgery of the turbinates. [4] The United Kingdom National Health Service has stated that "Most cases of atrophic rhinitis in the UK occur when the turbinates are damaged or removed during surgery". [5]
In the case of turbinate reduction, only small amounts of turbinate tissue are removed because the turbinates are essential for respiration. Turbinectomy is usually reserved for patients who have persistent symptoms despite previous turbinate reduction surgery. Risks of reduction of the inferior or middle turbinates include empty nose syndrome. [8]
In such a case the turbinate can be reduced in size by endoscopic nasal surgery (turbinectomy). The presence of a concha bullosa is often associated with deviation of the nasal septum toward the opposite side of the nasal cavity.
Procedures performed as part of a functional rhinoplasty typically include septoplasty, inferior turbinate reduction, and spreader graft placement. Results. Can be good if performed by an experienced practitioner. As in all plastic surgery procedures, there can be some unpredictability, and biologic systems can heal in different ways.