{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:58:07Z","timestamp":1784865487945,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T00:00:00Z","timestamp":1621036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>We sought to report the long\u2010term, symptom\u2010focused, prospective outcomes in empty nose syndrome (ENS) patients after undergoing inferior meatus augmentation procedure (IMAP) through use of four validated questionnaires: Empty Nose Syndrome 6\u2010Item Questionnaire (ENS6Q), 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022), Generalized Anxiety Disorder 7\u2010Item Scale (GAD\u20107), and Patient Health Questionnaire\u20109 (PHQ\u20109).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A single\u2010center prospective case series was performed for patients diagnosed with ENS who underwent IMAP between July 2017 and February 2020. Diagnosis of ENS was based on the following criteria: 1) reported discomfort with nasal breathing and\/or paradoxical nasal obstruction after inferior turbinate reduction, 2) a positive ENS6Q score of at least 11, and 3) a positive cotton test. Questionnaire responses were recorded prior to surgery as well as 1, 3, 6, and 12\u2009months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventeen eligible patients were included. Mean ENS6Q scores were significantly reduced at all postoperative time points (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0003). Of the six ENS6Q subdomains, five (suffocation, dryness, sense of diminished airflow, nasal crusting, and nasal burning) were significantly reduced 1\u2010year postoperatively (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0004, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0136, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0114, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0080, respectively). SNOT\u201022 scores were significantly reduced at all time points (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.0021, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0227, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0004, and <jats:italic>p<\/jats:italic>\u00a0=\u00a0.0025). Of the SNOT\u201022 subdomains, the sleep subdomain was significantly reduced 1\u2010year postoperatively (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.0432). Low baseline GAD\u20107 and PHQ\u20109 scores were recorded at 7 and 9.4, respectively, and although scores at all postoperative time points were reduced, there was no statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IMAP via implant of cadaveric rib cartilage provides significant, long\u2010term improvements in ENS\u2010specific and general sinonasal symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E2736\u2013E2741, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29593","type":"journal-article","created":{"date-parts":[[2021,5,15]],"date-time":"2021-05-15T12:21:21Z","timestamp":1621081281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Long\u2010Term Outcomes of Inferior Meatus Augmentation Procedure to Treat Empty Nose Syndrome"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4484-5123","authenticated-orcid":false,"given":"Sachi S.","family":"Dholakia","sequence":"first","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4383-1619","authenticated-orcid":false,"given":"Nicole A.","family":"Borchard","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-5880","authenticated-orcid":false,"given":"Michael T.","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashoke","family":"Khanwalkar","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Lechner","sequence":"additional","affiliation":[{"name":"Division of Rhinology, Department of Otolaryngology \u2013 Head and Neck Surgery Stanford University School of Medicine  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayakar V.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Veterans Affairs Palo Alto Health Care System  Palo Alto California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21842"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26549"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22299"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2011.25.3577"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-1955-1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23908"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812472436"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813491223"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21633"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819900263"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2009.01995.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.4787"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819866812"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22097"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26530"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28586"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22720"}],"container-title":["The 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