Inferior Turbinate Preservation Surgery: Surgical Strategies to Prevent Empty Nose Syndrome

Background: Inferior turbinate hypertrophy is one of the leading causes of chronic nasal obstruction and represents a frequent challenge in nasal surgical practice. Surgical management of this condition should aim not only to improve airflow but also to preserve nasal physiological function and minimize the risk of iatrogenic complications, particularly empty nose syndrome-an entity that can significantly impair patients' quality of life. Although traditionally addressed within otolaryngology, turbinate management is highly relevant in plastic surgery, particularly in rhinoplasty and septal procedures. Methods: A narrative review of the scientific literature published in English on inferior turbinate surgery, surgical techniques, and associated complications was conducted using the PubMed and Scopus databases, from their inception to September 2025. The search focused on surgical procedures, mucosal preservation strategies, and their relationship with functional outcomes and postoperative complications. Results: Critical analysis of the literature identified multiple surgical techniques with variable efficacy and safety profiles. Submucosal approaches demonstrated superior preservation of the mucosa, cilia, and thermoreceptors and were associated with lower rates of functional complications. In contrast, more aggressive procedures showed a stronger association with respiratory disturbances and the development of empty nose syndrome. Conclusions: Inferior turbinate hypertrophy can be effectively managed using mucosa-preserving surgical techniques, such as radiofrequency ablation, microdebrider-assisted turbinoplasty, and diode laser therapy. Appropriate technique selection and strict respect for nasal anatomy and physiology are essential to optimize functional outcomes and prevent severe long-term complications.