Empty Nose Syndrome - Surgery-Caused Autonomic And Respiratory Dysfunction

14/06/2026

12/06/2026

https://www.ent-istanbul.com/2025/09/overimplantation-and-nasal-congestion.html

Discussion on graft size and placement in Empty Nose Syndrome implantation, focusing on surgical approaches and patient outcomes.

08/06/2026

https://www.ent-istanbul.com/2026/05/cotton-test-and-surgical-planning-in-empty-nose-syndrome.html

Boş burun sendromunda sağ alt meatusa kıkırdak implantasyonu, pamuk testi ve endoskopik bulgularla detaylı anlatım.

08/06/2026

https://www.ent-istanbul.com/2021/10/nferior-meatus-augmentation.html

Narrowing of the nasal passage, augmentation of the inferior meatus with a cartilage graft in the treatment of nasal hyperventilation.

05/06/2026

https://share.google/LIHZXCfyIl9j36sKm

30/05/2026

Summary of the Study

Carnevale et al. (2011) – Effectiveness of Adaptive Servo-Ventilation in the Treatment of Hypocapnic Central Sleep Apnea of Various Etiologies

This study evaluated the long-term effectiveness of Adaptive Servo-Ventilation (ASV) in 74 patients with hypocapnic central sleep apnea (CSA), including patients with heart failure, neurological disorders, and idiopathic CSA. The average follow-up period was approximately 36 months.

The researchers found that ASV significantly improved sleep-disordered breathing:

* The apnea-hypopnea index (AHI) decreased from 47.4 to 6.9 events per hour.
* Nighttime oxygen saturation improved.
* Daytime sleepiness, measured by the Epworth Sleepiness Scale, was significantly reduced in patients who used ASV regularly.
* Patients with heart failure who were compliant with treatment also showed improvement in functional status (NYHA class).
* Importantly, ASV significantly reduced chronic hyperventilation, as demonstrated by blood gas measurements.

Average treatment adherence was good, with patients using ASV for approximately 5–6 hours per night.

Conclusion

The authors concluded that ASV is generally well tolerated and effective for most patients with hypocapnic central sleep apnea and chronic hyperventilation. The therapy improved breathing stability during sleep, reduced apnea events, improved oxygenation and daytime symptoms, and helped reduce chronic over-ventilation.

Our findings suggest that ASV is well tolerated and effective for most patients with hypocapnic central sleep apnea and chronic hyperventilation.

27/05/2026

https://denizyilmaz.com.tr/en/empty-nose-syndrome-ens/?fbclid=IwZXh0bgNhZW0CMTEAc3J0YwZhcHBfaWQKNjYyODU2ODM3OQABHnOTCp8KcYN-CfvtscCuO4f4OJ0NK0Puvc5dUM3hA_z1X9K4YcoGBMxYk6XT_aem_D8AR8VAuCUJRNzK96rd2cQ

Empty Nose Syndrome (ENS) diagnosis & treatment in Antalya, Turkey. International patients welcome. Prof. Dr. Mustafa Deniz Yılmaz, ENT specialist.

21/05/2026

Join the group here: https://www.facebook.com/groups/798149274095716/

19/05/2026

From the study:

Overall, these findings suggest that ENS symptom manifestation and ANS dysfunction may be closely interconnected. However, because causality cannot be established within the scope of this study, it remains possible that chronic nasal symptoms and mucosal alterations associated with ENS may secondarily induce ANS dysfunction.

Study summary

Title: Assessment of Autonomic Dysfunction in Patients With Empty Nose Syndrome Using the Composite Autonomic Symptom Scale-31
Journal: Journal of Rhinology (J Rhinol), 2025;32(3):162–168
DOI: 10.18787/jr.2025.00043

Authors: Sung Seok Ryu, MD; Do Yeon Kim, MD; Yong Ju Jang, MD, PhD
Institution: Department of Otorhinolaryngology–Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Objective

The study investigated whether patients with Empty Nose Syndrome (ENS) show evidence of autonomic nervous system (ANS) dysfunction, using the validated questionnaire COMPASS-31, compared with asymptomatic controls.

Methods
26 ENS patients and 43 control participants were included.
ENS diagnosis was based on:
history of turbinate surgery
characteristic symptoms
endoscopic/CT findings
ENS6Q questionnaire (and in some cases cotton test confirmation)
ENS patients completed both COMPASS-31 (autonomic symptoms) and ENS6Q (nasal symptoms).
Controls completed COMPASS-31 only.
Key results
ENS patients had significantly higher total COMPASS-31 scores than controls, indicating a greater burden of autonomic symptoms.
No strong overall correlation was found between total ENS symptom severity (ENS6Q) and COMPASS-31 scores.
However, nasal crusting severity showed a significant positive correlation with COMPASS-31 scores.
Main findings
ENS is associated with increased symptoms consistent with autonomic dysfunction, including dryness, sweating abnormalities, and urinary symptoms.
Most individual autonomic domains were not significantly different between groups.
The link between ENS and autonomic dysfunction appears partial and symptom-specific rather than uniform across all systems.
Conclusion

The study suggests that ENS is associated with increased autonomic symptom burden and possible autonomic nervous system involvement, particularly related to nasal mucosal function and crusting. However, causality cannot be established.

Simple interpretation

Patients with ENS show more signs consistent with autonomic dysregulation compared to controls, but the study does not prove that ENS directly causes autonomic dysfunction—only that they are associated.