Empty nose syndrome with audiological abnormalities after surgical treatment of chronic rhinosinusitis with nasal polyps: a case report

Empty nose syndrome (ENS) is a rare iatrogenic complication of ENT surgery caused by excessive resection of intranasal structures and associated with impaired physiological nasal airflow. In addition to classic manifestations, atypical auditory symptoms may occur and complicate timely diagnosis. We report a 26-year-old patient with ENS after surgical treatment of chronic rhinosinusitis with nasal polyps. ENS was accompanied by paradoxical nasal obstruction, recurrent auditory symptoms, ear fullness, audiological abnormalities, and Eustachian tube dysfunction. Diagnosis of ENS was based on medical history, clinical findings, nasal endoscopy, and computed tomography of paranasal sinuses. Middle-ear sound-conduction function was assessed by tympanometry. Treatment included nasal mucosal humidification and endonasal ultraphonophoresis with Fermenkol using the Tonsillor-MM device. Treatment decreased pain and auditory symptoms, while nasal breathing improved. This case illustrates the value of instrumental assessment and restorative technologies in management of ENS after ENT surgery.