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Empty Nose Syndrome (ENS)
Simulated Surgery

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CT Scan

By increasing size of the lower turbinate, the area of the left nasal cavity is reduced from 1.6cm   to 1.2cm   at a distance of 3.0cm from the nostril tip.

Similarly, by increasing size of the lower turbinate the area of the right nasal cavity is reduced from 1.2cm  to 0.8cm  at a distance of 3.0cm from the nostril tip.

The reduced area results in increased contact between turbinates and airflow aids in breathing perception.

Before Simulated Surgery

After Simulated Surgery

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Before Simulated Surgery

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After Simulated Surgery

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Airflow Distribution

After simulated surgery airflow is reduced from 18L/min to 15L/min in the right airway and from 24L/min to 18L/min in the left airway. Ventilation of the inferior meatus is increased from 1L/min to 2L/min in both the right and left airway.

No Airflow

0.0 L/min < Airflow < 0.5 L/min

0.5 L/min < Airflow < 1.5 L/min

1.5 L/min < Airflow < 3.5 L/min

3.5 L/min < Airflow < 5.0 L/min

5.0 L/min < Airflow < 7.0 L/min

7.0 L/min < Airflow 

Airflow Pressure

Before simulated surgery the only region experiencing pressure drop is between 0cm-2cm.

 

After turbinate enlargement simulation, the region of pressure drop is increased to 0cm-4cm in the right airway and 0cm to 3cm in the left airway.

Before Simulated Surgery

After Simulated Surgery

After Simulated Surgery

Before Simulated Surgery

Airflow Velocity

Airflow velocity presents negligible changes before and after simulated surgery.

 

This is because as the airway area is decreased after simulated surgery, volumetric airflow decreases too. For this to happen airflow velocity must remain unchanged.

Airflow Temperature

Before simulated surgery airflow enters the airway from the nostril and is warmed to 26°C at a distance of 3cm from the left and right nostril and reaches a temperature of 35°C at a distance of 5cm from the nostril.

After simulated surgery, temperature reaches a value of 35°C (left) and 33°C (right) at a distance of 5cm from the nostril tip.

Before Simulated Surgery

After Simulated Surgery

After Simulated Surgery

Before Simulated Surgery

Airflow Humidity

Air enters the nasal cavity at 28% humidity. As air temperature increases humidity decreases to 8%.

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