Endoscopic view of an "empty nose"

February 25, 2013 by Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
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Rhinoscopic Clinic

The empty nose syndrome usually is defined by excessive loss of normal nasal tissue and loss of anatomic landmarks, which results in a widely patent airway with excessive crusting (ozena) and easy nasal bleeding and dryness of the nasal mucosa. Functional endoscopic sinus surgery for chronic sinus disease has diminished the possibility of the difficult empty nose.

A 74-year-old man presented with recurrent nasal bleeding and nasal crusting. He reported a history of nasal and sinus surgery performed on the left side for polyps 42 years earlier. For 40 of the 42 years he accepted the infrequent nosebleeds, but since requiring daily aspirin as a blood thinner for the previous 2 years, he was having more frequent and troublesome nosebleeds on the left side. This was particularly bothersome after he used saline irrigations, which had been part of his daily routine since his original nasal surgery.

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