{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:00:16Z","timestamp":1780714816374,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n The objective of this study was to assess the clinical efficacy and safety of topical nitroglycerin ointment in patients diagnosed with empty nose syndrome (ENS).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n ENS was diagnosed based on clinical history, nasal endoscopic findings, a positive cotton test, and an Empty Nose Syndrome 6\u2010Item Questionnaire (ENS6Q) score of \u2265\u200911. Patients who met the inclusion criteria were instructed to apply a topical nitroglycerin ointment (Rectogesic, glyceryl trinitrate 0.2%) three times daily. The mean age was 42.09\u2009years, with a male\u2010to\u2010female ratio of 3:1. Pre\u2010 and posttreatment ENS6Q scores were compared, and subjective symptom improvement was analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The total ENS6Q score showed a significant improvement, dropping from 17.32\u2009\u00b1\u20094.34 to 12.52\u2009\u00b1\u20095.21 (\n p\u2009<<\/jats:italic>\n \u20090.001). All six ENS6Q items showed significant improvements, with the greatest reduction observed in nasal dryness (4.16 to 2.86,\n p\u2009<<\/jats:italic>\n \u20090.001). Sixteen patients (36.4%) showed moderate improvement (\u0394ENS6Q\u2009=\u20093 to 6). Fifteen patients (34.1%) showed marked improvement (\u0394ENS6Q\u2009>\u20096), exceeding the minimal clinically important difference. Subjective symptom improvement was reported by 27 patients (61.4%), who demonstrated significantly greater ENS6Q improvement than those without symptom improvement (\u0394ENS6Q 7.22\u2009\u00b1\u20094.99 vs. 0.94\u2009\u00b1\u20092.41,\n p<\/jats:italic>\n \u2009<\u20090.001). Eleven patients (25.0%) reported adverse effects; mild headache was the most common symptom (\n n<\/jats:italic>\n \u2009=\u20096, 54.5% of adverse effects). The presence of adverse effects did not have a significant impact on treatment duration.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Topical nitroglycerin showed promising preliminary results and may represent a potential conservative treatment option for ENS, an uncommon yet serious complication arising after turbinate volume reduction surgery.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70661","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T02:10:17Z","timestamp":1780711817000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Efficacy of Topical Nitroglycerin Ointment for Patients With Empty Nose Syndrome"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5861-7386","authenticated-orcid":false,"given":"Sung Seok","family":"Ryu","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Asan Medical Center, University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohee","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Asan Medical Center, University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Ju","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Asan Medical Center, University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.anorl.2012.02.001","article-title":"Empty Nose Syndrome","volume":"129","author":"Coste A.","year":"2012","journal-title":"European Annals of Otorhinolaryngology, Head and Neck Diseases"},{"issue":"9","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"3935","DOI":"10.1002\/lary.31414","article-title":"Application of a Novel 3D\u2010Printed Nasal Plug as a Conservative Treatment for Empty Nose Syndrome","volume":"134","author":"Gwak J. W.","year":"2024","journal-title":"Laryngoscope"},{"issue":"6","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1002\/lary.21734","article-title":"Empty Nose Syndrome: Radiologic Findings and Treatment Outcomes of Endonasal Microplasty Using Cartilage Implants","volume":"121","author":"Jang Y. J.","year":"2011","journal-title":"Laryngoscope"},{"issue":"6","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1002\/lary.25814","article-title":"Evaluation of Depression and Anxiety in Empty Nose Syndrome After Surgical Treatment","volume":"126","author":"Lee T. J.","year":"2016","journal-title":"Laryngoscope"},{"key":"e_1_2_11_6_1","first-page":"707","volume-title":"The Functional and Psychological Burden of Empty Nose Syndrome","author":"Manji J.","year":"2018"},{"issue":"3","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/01945998211052919","article-title":"Empty Nose Syndrome Pathophysiology: A Systematic Review","volume":"167","author":"Kanjanawasee D.","year":"2022","journal-title":"Otolaryngology\u2013Head and Neck Surgery"},{"issue":"3","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.21053\/ceo.2023.00038","article-title":"Surgical and Regenerative Treatment Options for Empty Nose Syndrome: A Systematic Review","volume":"17","author":"Basurrah M. A.","year":"2024","journal-title":"Clinical and Experimental Otorhinolaryngology"},{"issue":"9","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1001\/archotol.133.9.858","article-title":"Surgical Treatment for Empty Nose Syndrome","volume":"133","author":"Houser S. M.","year":"2007","journal-title":"Archives of Otolaryngology \u2013 Head & Neck Surgery"},{"issue":"3","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1177\/0194599813491223","article-title":"Costal Cartilage Is a Superior Implant Material Than Conchal Cartilage in the Treatment of Empty Nose Syndrome","volume":"149","author":"Jung J. H.","year":"2013","journal-title":"Otolaryngology and Head and Neck Surgery"},{"issue":"4","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.21053\/ceo.2017.01634","article-title":"Efficacy and Safety of Autologous Stromal Vascular Fraction in the Treatment of Empty Nose Syndrome","volume":"11","author":"Kim D.\u2010Y.","year":"2018","journal-title":"Clinical and Experimental Otorhinolaryngology"},{"issue":"1","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s11882-014-0493-x","article-title":"Empty Nose Syndrome","volume":"15","author":"Kuan E. C.","year":"2015","journal-title":"Current Allergy and Asthma Reports"},{"key":"e_1_2_11_13_1","first-page":"NP150","article-title":"An Updated Review on Atrophic Rhinitis and Empty Nose Syndrome","volume":"105","author":"Sumaily I. A.","year":"2023","journal-title":"Ear, Nose, & Throat Journal"},{"issue":"8","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1002\/lary.26549","article-title":"Defining Surgical Criteria for Empty Nose Syndrome: Validation of the Office\u2010Based Cotton Test and Clinical Interpretability of the Validated Empty Nose Syndrome 6\u2010Item Questionnaire","volume":"127","author":"Thamboo A.","year":"2017","journal-title":"Laryngoscope"},{"issue":"19","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"2393","DOI":"10.1016\/j.jacc.2017.09.1064","article-title":"The Role of Nitroglycerin and Other Nitrogen Oxides in Cardiovascular Therapeutics","volume":"70","author":"Divakaran S.","year":"2017","journal-title":"Journal of the American College of Cardiology"},{"issue":"5","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1463-1318.2006.01134.x","article-title":"Rectogesic (Glyceryl Trinitrate 0.2%) Ointment Relieves Symptoms of Haemorrhoids Associated With High Resting Anal Canal Pressures","volume":"9","author":"Tjandra J.","year":"2007","journal-title":"Colorectal Disease"},{"issue":"4","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.3390\/pharmaceutics15041060","article-title":"Topical Drug Delivery in the Treatment of Skin Wounds and Ocular Trauma Using the Platform Wound Device","volume":"15","author":"Eriksson E.","year":"2023","journal-title":"Pharmaceutics"},{"issue":"2","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1002\/lio2.767","article-title":"Comparison of SNOT\u201025 and ENS6Q in Evaluating Patients With Empty Nose Syndrome","volume":"7","author":"Huang C. C.","year":"2022","journal-title":"Laryngoscope Investigative Otolaryngology"},{"key":"e_1_2_11_19_1","first-page":"64","volume-title":"The Empty Nose Syndrome 6\u2010Item Questionnaire (ENS6Q): A Validated 6\u2010Item Questionnaire as a Diagnostic Aid for Empty Nose Syndrome Patients","author":"Velasquez N.","year":"2017"},{"issue":"4","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s10151-011-0725-1","article-title":"Treatment of Chronic Anal Fissure With Topical Nitroglycerin Ointment 0.4%: A Prospective Clinical Study","volume":"15","author":"Perez\u2010Legaz J.","year":"2011","journal-title":"Techniques in Coloproctology"},{"issue":"7","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"2635","DOI":"10.3390\/jcm12072635","article-title":"Identifying Residual Psychological Symptoms After Nasal Reconstruction Surgery in Patients With Empty Nose Syndrome","volume":"12","author":"Huang C.\u2010C.","year":"2023","journal-title":"Journal of Clinical Medicine"},{"issue":"3","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"162","DOI":"10.18787\/jr.2025.00043","article-title":"Assessment of Autonomic Dysfunction in Patients With Empty Nose Syndrome Using the Composite Autonomic Symptom Scale\u201031","volume":"32","author":"Ryu S. 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L.","year":"2007","journal-title":"Otolaryngology and Head and Neck Surgery"},{"issue":"6","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"E176","DOI":"10.1002\/lary.26530","article-title":"Computational Fluid Dynamics and Trigeminal Sensory Examinations of Empty Nose Syndrome Patients","volume":"127","author":"Li C.","year":"2017","journal-title":"Laryngoscope"},{"key":"e_1_2_11_25_1","first-page":"444","volume-title":"Investigation of the Abnormal Nasal Aerodynamics and Trigeminal Functions Among Empty Nose Syndrome Patients","author":"Li C.","year":"2018"},{"issue":"3","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000109439","article-title":"The Role of the Autonomic Nerves in the Control of Nasal Circulation","volume":"4","author":"Lung M. A.","year":"2004","journal-title":"Neuro\u2010Signals"},{"issue":"5","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1002\/lary.23908","article-title":"Study of Inferior Turbinate Reconstruction With Medpor for the Treatment of Empty Nose Syndrome","volume":"123","author":"Jiang C.","year":"2013","journal-title":"Laryngoscope"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70661","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70661","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T02:10:21Z","timestamp":1780711821000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":26,"alternative-id":["10.1002\/lary.70661"],"URL":"https:\/\/doi.org\/10.1002\/lary.70661","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"assertion":[{"value":"2026-03-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.70661"}}