{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:25:05Z","timestamp":1778693105055,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T00:00:00Z","timestamp":1711152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG1M0151"],"award-info":[{"award-number":["CMRPG1M0151"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG1L0091"],"award-info":[{"award-number":["CMRPG1L0091"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Empty nose syndrome (ENS) is an underdiagnosed but burdensome clinical condition. Studies that have addressed the impact of remnant inferior turbinate volume (ITV) on ENS are scarce. We aimed to evaluate the impact of ITV and phenotyping on the severity and presentation of ENS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All the enrolled patients underwent the following subjective assessments: the ENS 6\u2010Item Questionnaire (ENS6Q), Sino\u2010Nasal Outcome Test\u201025 (SNOT\u201025), Beck Depression Inventory\u2010II (BDI\u2010II) and Beck Anxiety Inventory (BAI). The ITV was obtained from finely cut (1\u2010mm\u2010thick slices) sino\u2010nasal computed tomography scan images and analyzed using ImageJ. The correlation between ITV, subjective measurements, and morphology of inferior turbinates was evaluated. ENS was categorized as torpedo type (balanced tissue volume) or pistol type (posterior dominance) based on the morphology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 54 patients met the inclusion criteria. The ITV was positively correlated with the ENS6Q score and domain of ENS symptoms in SNOT\u201025. Neither BDI\u2010II nor BAI scores had a significant correlation with ITV. Based on their morphological classification, the torpedo type exhibited diverse manifestations in the SNOT\u201025 analysis in response to changes in ITV, while the pistol type demonstrated an elevated rhinologic symptom burden and ENS\u2010specific symptoms as their ITV increased. Nasal resistance did not correlate with the ITV in either type of ENS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Symptoms were paradoxically worse in ENS patients with greater remnant ITV, and distinct morphological phenotypes in the nasal cavities may result in different presentations. Further investigation into the correlation between remnant inferior turbinates and nerve function is warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:3060\u20133066, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31328","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T18:23:06Z","timestamp":1711218186000},"page":"3060-3066","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Morphology, Not Only Volume: A Study on Empty Nose Syndrome and Inferior Turbinates"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6510-0876","authenticated-orcid":false,"given":"Chia\u2010Hsiang","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien\u2010Cheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi\u2010Che","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8725-6209","authenticated-orcid":false,"given":"Po\u2010Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya\u2010Cheng","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ta\u2010Jen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2009.02.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26769"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.9.858"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2005.04.017"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25814"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino13.086"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24813"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084243"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22720"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1045"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21842"},{"key":"e_1_2_7_13_1","unstructured":"Chinese Behavioral Science Corporation. 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