Pathophysiology of empty nose syndrome.

OBJECTIVES/HYPOTHESIS To review current knowledge on nasal airflow sensation in relation to empty nose syndrome (ENS). STUDY DESIGN PubMed searches. METHODS Current literature pertaining to measurement of nasal patency, mechanism of sensory perception of nasal airflow, and ENS. RESULTS A reliance on pure anatomical analysis of the anatomy in ENS falls short of explaining the disorder. Our understanding of subjective nasal sensation has advanced, as has our understanding of the flow of air through the nose. Neural healing following a surgical insult may not result in a return to a normal physiologic state. Aberrations in neurosensory systems from improper healing may play a major role in the abnormal sensations ENS patients experience. CONCLUSIONS An evidence-based hypothesis for the development and symptoms of ENS is offered.