Suicidal thoughts in patients with empty nose syndrome

Chien-Chia Huang; Pei-Wen Wu; Cheng-Chi Lee; Po-Hung Chang; Chi-Che Huang; Ta-Jen Lee

doi:10.1002/lio2.730

Suicidal thoughts in patients with empty nose syndrome

Laryngoscope Investig Otolaryngol. 2022 Jan 19;7(1):22-28. doi: 10.1002/lio2.730. eCollection 2022 Feb.

Authors

Chien-Chia Huang^{1

2

3}, Pei-Wen Wu^{1

4}, Cheng-Chi Lee^{5

6}, Po-Hung Chang^{1

2

3}, Chi-Che Huang^{1

2

3}, Ta-Jen Lee^{1

3

7}

Affiliations

¹ Division of Rhinology, Department of Otolaryngology Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan.
² Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University Taoyuan Taiwan.
³ School of Medicine, Chang Gung University Taoyuan Taiwan.
⁴ Department of Otolaryngology-Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University Keelung Taiwan.
⁵ Department of Neurosurgery Chang Gung Memorial Hospital at Linkou Taoyuan Taiwan.
⁶ Department of Biomedical Engineering National Taiwan University Taipei Taiwan.
⁷ Department of Otolaryngology Xiamen Chang Gung Hospital Xiamen China.

Abstract

Objectives: Patients with empty nose syndrome (ENS) suffer from paradoxical nasal obstruction with a patent objective nasal airway. ENS may result from the excessive surgical reduction of the turbinate tissue. ENS patients also experience significant psychological symptoms such as anxiety and depression. In this study, we aimed to evaluate the prevalence of suicidal thoughts in ENS patients and to characterize these patients for early identification.

Study design: Prospective case series.

Methods: Patients with ENS were prospectively recruited for this study. The Sino-Nasal Outcome Test-25 (SNOT-25), Empty Nose Syndrome 6-item Questionnaire (ENS6Q), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II) were used to assess ENS patients before and 6 months after nasal reconstruction surgery.

Results: Sixty-two patients with ENS were enrolled. Suicidal thoughts were identified in 23 ENS patients preoperatively and in four patients postoperatively. ENS patients with suicidal thoughts rated significantly higher in the SNOT-25, ENS6Q, BDI-II, and BAI total scores than those without suicidal thoughts (all P < .05). "Nose feels too open" was the item in ENS6Q that was significantly more severe in ENS patients with suicidal thoughts than those without suicidal thoughts (P < .001).

Conclusions: Suicidal thoughts are frequently identified in patients with ENS. ENS patients with suicidal thoughts experienced significantly more severe symptoms, impaired quality of life, and psychological burden than those without suicidal thoughts. Recognizing individuals who may carry suicidal thoughts and provide appropriate psychological interventions is critical to prevent tragedy.

Level of evidence: 4.

Keywords: Beck Depression Inventory II; Empty Nose Syndrome 6‐item Questionnaire; depression; empty nose syndrome; suicidal thoughts.