Inferior turbinate reconstruction using porcine small intestine submucosal xenograft demonstrates improved quality of life outcomes in patients with empty nose syndrome.
BACKGROUND
We describe the surgical technique for use of small intestine submucosal (SIS) xenograft implant for inferior turbinate reconstruction and report our early results in a pilot case series of patients suffering from symptoms consistent with empty nose syndrome (ENS).


METHODS
We report an observational prospective cohort study of ENS patients undergoing inferior turbinate reconstruction using porcine SIS xenograft. Effects of the procedure on quality of life (QOL) were assessed through serial 25-item Sino-Nasal Outcome Test (SNOT-25) scores and analyzed by 1-way analysis of variance (ANOVA) between the initial visit and 1, 4, and 12 weeks after surgery.


RESULTS
Three patients with ENS underwent inferior turbinate reconstruction. No unexpected complications were noted over the 12-week follow-up course. Despite mild partial reabsorption of the SIS implant, neoturbinates were maintained in all patients. The mean preoperative score SNOT-25 was 77.6 (maximum 125). The mean postoperative scores were 65 at 1 week, 57 at 4 weeks, and 55 at 12 weeks (p < 0.01). Furthermore, for the "difficulty with nasal breathing" and "nose is too open" subdomains, statistically significant improvement was also noted at weeks 4 and 12 postoperatively (p < 0.05 and p <0.01, respectively).


CONCLUSION
The use of porcine SIS xenograft for inferior turbinate reconstruction appears to be safe and effective in the treatment of patients diagnosed with ENS. This study demonstrates statistically significant improvement in global QOL metrics and nasal-specific subdomains following inferior turbinate reconstruction/neoturbinate creation for ENS as evaluated through serial SNOT-25 scores.
['Velasquez|Nathalia|N|', 'Huang|Zhenxiao|Z|', 'Humphreys|Ian M|IM|', 'Nayak|Jayakar V|JV|']
D000818:Animals D004417:Dyspnea D005260:Female D005500:Follow-Up Studies D006801:Humans D007413:Intestinal Mucosa D007421:Intestine, Small D008297:Male D015508:Nasal Obstruction D009668:Nose Diseases D011446:Prospective Studies D019736:Prostheses and Implants D011788:Quality of Life D012225:Rhinoplasty D011795:Surveys and Questionnaires D013552:Swine D013577:Syndrome D014183:Transplantation, Heterologous D016896:Treatment Outcome D014420:Turbinates
inferior turbinate reconstruction empty nose syndrome neoturbinate endoscopic sinus surgery porcine small intestine xenograft turbinate reduction