NASAL NITRIC OXIDE IN RELATION TO PSYCHIATRIC STATUS OF PATIENTS WITH EMPTY NOSE SYNDROME

Summary of the Study on Nasal Nitric Oxide (nNO) and Psychiatric Status in Empty Nose Syndrome (ENS) Patients

This study explored the relationship between nasal nitric oxide (nNO) levels and psychiatric health in patients with Empty Nose Syndrome (ENS). ENS is a rare but severe condition often caused by excessive removal of nasal tissue during surgery. Symptoms include a paradoxical sensation of nasal blockage despite an open airway, dryness, difficulty breathing, sleep issues, anxiety, and depression. The study focused on whether nNO, a molecule produced in the nasal passages that plays a role in immune defense and ciliary function, could be a useful indicator for monitoring the condition and its associated mental health impacts.

Background

Nasal nitric oxide (nNO) is typically used as a biomarker for various airway conditions. For example, nNO levels are known to increase after surgeries for sinusitis, reflecting improved sinus function. However, the role of nNO in ENS, particularly how it changes after surgical treatment and how it relates to psychiatric symptoms like anxiety and depression, had not been previously explored. This study aimed to fill that gap.

Methods

The study involved two groups of patients: 19 with ENS and 12 with chronic hypertrophic rhinitis (CHR), a condition characterized by the thickening of nasal tissue, who served as a comparison group. All patients underwent surgical treatments—submucosal implantation for ENS patients and turbinoplasty for CHR patients. The researchers measured nNO levels and assessed psychiatric symptoms using standardized questionnaires (SinoNasal Outcome Test-22, Beck Depression Inventory-II, and Beck Anxiety Inventory) before surgery and at 3, 6, and 12 months after surgery.

Key Findings

Lower nNO Levels in ENS Patients: Before surgery, ENS patients had significantly lower nNO levels compared to CHR patients. This finding was consistent with the fact that ENS is associated with disrupted nasal physiology.

Post-Surgery Increase in nNO for ENS Patients: After undergoing submucosal implantation surgery, ENS patients showed a significant increase in nNO levels by the third month, which then plateaued and remained stable at 6 and 12 months. This suggests that the surgery helped restore some of the nasal functions in these patients.

Improvement in Psychiatric Symptoms: Alongside the increase in nNO levels, ENS patients experienced significant reductions in symptoms of depression and anxiety, as measured by the Beck Depression Inventory-II and Beck Anxiety Inventory. These improvements were not observed in CHR patients, who had normal psychiatric scores before surgery.

Correlation Between nNO and Psychiatric Health: The study found a significant correlation between the increase in nNO levels and the improvement in psychiatric symptoms in ENS patients. This suggests that nNO could potentially be used to monitor not only the physical recovery of ENS patients but also their mental health.

Different Responses in CHR Patients: CHR patients, who had higher nNO levels to begin with, did not show significant changes in nNO levels after their surgery, and their psychiatric symptoms remained stable, indicating a different mechanism of disease and recovery compared to ENS.

Conclusions

The study concluded that nNO levels are significantly lower in ENS patients compared to those with CHR, and that these levels increase following surgical intervention, paralleling improvements in anxiety and depression. This suggests that nNO could serve as an important biomarker for both the physical and psychological health of ENS patients. The findings offer new insights into the complex relationship between nasal physiology and mental health in ENS, highlighting the potential of nNO as a tool for monitoring patient outcomes post-surgery. Future research could explore this further and determine whether nNO measurements could become a standard part of ENS treatment protocols.

Evaluation of Depression and Anxiety in Empty Nose Syndrome After Surgical Treatment

The research report titled "Evaluation of Depression and Anxiety in Empty Nose Syndrome" investigates the psychological effects of Empty Nose Syndrome (ENS) and how surgical treatment can improve the mental health of patients suffering from this condition. ENS is a condition that can occur after nasal surgery, leading to a feeling of excessive nasal emptiness, which can cause various physical and psychological symptoms.

Summary of the Study

Background: ENS is not just about physical changes in the nasal cavity; it also involves psychological aspects. Patients often report feelings of anxiety and depression, which can significantly affect their quality of life. The study aimed to evaluate these psychological symptoms and see if surgical intervention could help.

Methods: The researchers used two main psychological assessment tools: the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). These tools help measure the levels of depression and anxiety in patients. The study involved patients who underwent a specific surgical procedure called endonasal submucosal implantation, where a material (Medpor) or bone grafts were placed in the nasal cavity to improve airflow and reduce symptoms.

Surgical Procedure: The surgery was performed under local anesthesia. The surgeons created a pocket in the nasal wall to insert the implant, aiming to restore a more normal nasal structure and function. The goal was to alleviate the symptoms of ENS and improve the patients' overall well-being.

Findings: After the surgery, patients showed significant improvements in both their depression and anxiety scores. The results indicated that many patients felt less anxious and depressed after the procedure. For example, specific symptoms like feelings of fear, nervousness, and difficulty relaxing were notably reduced.

Conclusions: The study concluded that surgical treatment for ENS not only helps with physical symptoms but also leads to significant improvements in psychological health. This suggests that addressing the physical aspects of ENS can have a positive ripple effect on mental health, providing a better quality of life for patients.

Key Takeaways

ENS is a complex condition that affects both the body and mind. Surgical intervention can effectively reduce symptoms of depression and anxiety in ENS patients. The study highlights the importance of considering psychological health when treating patients with ENS. Overall, this research emphasizes the need for a holistic approach to treating ENS, where both physical and psychological aspects are addressed to improve patient outcomes.