{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:55:42Z","timestamp":1791291342288,"version":"4.3.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T00:00:00Z","timestamp":1543449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R01 DC013626"],"award-info":[{"award-number":["R01 DC013626"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Empty nose syndrome (ENS) is a rare and debilitating disease with a controversial definition, etiology, and treatment. One puzzling fact is that patients who undergo an endoscopic endonasal approach (EEA) often have resection of multiple anatomic structures, yet seldom develop ENS. In this pilot study, we analyzed and compared the computational fluid dynamics (CFD) and symptoms among post\u2010EEA patients, ENS patients, and healthy subjects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Computed tomography scans of 4 post\u2010EEA patients were collected and analyzed using CFD techniques. Two patients had significant ENS symptoms based on results of the Empty Nose Syndrome 6\u2010item Questionnaire (score &gt;11), whereas the other 2 were asymptomatic. As a reference, their results were compared with previously published CFD results of 27 non\u2010EEA ENS patients and 42 healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Post\u2010EEA patients with ENS symptoms had a similar nasal airflow pattern as non\u2010EEA ENS patients. This pattern differed significantly from that of EEA patients without ENS symptoms and healthy controls. Overall, groups with ENS symptoms exhibited airflow dominant in the middle meatus region and a significantly lower percentage of airflow in the inferior turbinate region (EEA with ENS, 17.74 \u00b1 4.00% vs EEA without ENS, 51.25 \u00b1 3.33% [<jats:italic>t<\/jats:italic> test, <jats:italic>p<\/jats:italic> &lt; 0.02]; non\u2010EEA ENS, 25.8 \u00b1 17.6%; healthy subjects, 36.5 \u00b1 15.9%) as well as lower peak wall shear stress (EEA with ENS, 0.30 \u00b1 0.13 Pa vs EEA without ENS, 0.61 \u00b1 0.03 Pa [<jats:italic>p<\/jats:italic> = 0.003]; non\u2010EEA ENS, 0.58 \u00b1 0.24 Pa; healthy subjects, 1.18 \u00b1 0.81 Pa).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results suggest that turbinectomy and\/or posterior septectomy may have a varying functional impact and that ENS symptoms go beyond anatomy and correlate with aerodynamic changes. The findings open the door for CFD as a potential objective diagnosis tool for ENS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22236","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T09:17:39Z","timestamp":1543483059000},"page":"204-211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Computational fluid dynamics after endoscopic endonasal skull base surgery\u2014possible empty nose syndrome in the context of middle turbinate resection"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-3544","authenticated-orcid":false,"given":"Guillermo","family":"Maza","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8379-2423","authenticated-orcid":false,"given":"Chengyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"},{"name":"Department of Mechanical Engineering Villanova University  Villanova PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian P.","family":"Krebs","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"},{"name":"Department of Biomedical Engineering The Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander A.","family":"Farag","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo L.","family":"Carrau","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery The Ohio State University  Columbus OH"},{"name":"Department of Biomedical Engineering The Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26530"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22045"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.04.017"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21842"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21319"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24265"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjh033"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.2794204"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21951"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2017.2296"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1603788"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1607209"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjy013"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjh033"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjj008"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2017.08.031"},{"key":"e_1_2_6_18_1","first-page":"707","article-title":"The functional and psychological burden of empty nose syndrome","volume":"2018","author":"Manji J","journal-title":"Int Forum Allergy Rhinol"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2009.02.002"},{"key":"e_1_2_6_20_1","first-page":"Doc03","article-title":"Surgery of the turbinates and \u201cempty nose\u201d syndrome","volume":"9","author":"Scheithauer MO.","year":"2010","journal-title":"GMS Curr Top Otorhinolaryngol Head Neck Surg"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0024618"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26491"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2005.19.1.4"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816644915"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.23033"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.08.013"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21483"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.21037\/ajo.2018.01.02"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4150"}],"container-title":["International Forum of Allergy &amp; 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