Empty nose syndrome (ENS), also known in research as "the wide nasal cavity syndrome", is a medical term used to describe a nose crippled by over resection of the inferior and/or middle turbinates of the nose. 
Empty nose syndrome is a iatrogenic condition that can and should be completely avoided, except for the rare cases of cancerous tumours in the nasal cavity, in which radical resection of nasal structures may be mandatory.
Over resection of the inferior or middle turbinates leaves the nose in a chronic state of dryness (lack of mucus/moisture production) and incapable of streamlining, sensing (motion and temperature wise) and processing the inhaled air in a satisfactory manner.
The main symptoms are - chronic dryness of the nose and pharynx, shortness of breath, upsetting nasal sensations switching between over openness or congestion of the remaining mucosa, difficulty sleeping, difficulty concentrating and a generally depressed and irritated mood.
The patients feel confusing sensations of too much air entering their nose and pharynx, yet at the same time they feel that they need more nasal resistance to breathe-in satisfactorily. Patients may report that their nose feels un-responsive, too empty and at the same time stuffy, or that although they can sense plenty of air passing through their noses towards their lungs, they feel as if they can't catch their breath and as if their lungs are constantly starved for air. Paradoxically their shortness of breath improves when their nasal mucosa becomes swollen and their nasal resistance increases, like when their nose becomes infected or after drinking a lot of alcohol.
ENS is a physically, cognitively and emotionally debilitating condition as good nasal functions are crucial for proper lung functions and breathing, cognitive functions, and sense of well-being.
* Nose feels too empty/hollow/absent.
* Diminished nasal airflow sensation feedback ('paradoxical obstruction').
* Extreme sensation of dryness of the nasal cavities, with or without crusting.
* Not enough moisture/mucus production.
* Dryness of the pharynx, soft palate and back of the tongue ("dry pharyngitis" and "dry laryngitis").
* Feeling of needing more nasal resistance (or nasal membrane responsiveness) to breathe.
* Increased pulmonary sensitivity to air-borne irritants, strong scents and cold air. Causes much uneasiness in breathing and sometimes even long-periods (can last hours) of severe shortness of breath, depending on the degree of exposure.
* Diminished sense of smell and/or taste. Can be confusing - because although there is diminished sense of smell there is also hyper-responsiveness to light and volatile airborne chemicals, fumes and irritants.
* Difficulty projecting or resonating speech. The voice seems weak and requires some straining to sound loud and articulate well, which causes uneasiness in speech.
* Feeling weak and depleted of energy.
* Very poor quality of sleep. Not necessarily full sleep apnea, but shallow and dry breathing, which often switches entirely to mouth breathing only, waking up a lot very dry, with headaches, severe dizziness and very little REM sleep.
* Relatively dry skin and eyes.
* Difficulty concentrating ('aprosexia nasalis').
* Difficulty performing mental tasks.
* Marked reduction in sense of self and very crippled sense of well-being.
* Irritated and/or depressed mood. Often clinical depression.
* Avoidance of social interactions.
other characteristic physical symptoms that many ENS patients develop
* irritating sensation of thick stagnant mucus stuck at the back of the throat. Because of the dryness of the mucosa the mucus propelled to the throat (on the way to the stomach - the nasal mucociliary clearance that occurs in all humans) simply becomes too dry and sticks to the sides of the throat instead of sliding smoothly unfelt.
* Chronic sinusitis.
* Worsening of pre surgical nasal symptoms, such as allergic rhinitis, etc'.
* Hardly any mucus production, or the opposite – episodes of excessive rhinoreah.
* Foul smell from nasal cavities.
* Gastroesophageal reflux (GERD).
* Elevated levels of blood pressure.
* Hormonal and metabolic imbalances.
* Significant weight gain.
The roles of the turbinates and how their absence causes symptoms of ENS
The nasal turbinates are elongated bony structures, covered with nasal mucosa, that project off the nasal side walls and stretch across the entire nasal airway. In adults - the inferior turbinate is about the size of an index finger and the middle turbinate is about the size of the small finger. They are the most important mucosal and moisture secreting structures of the nose and they serve to heat regulate (to body temperature), humidify (to 98% humidity), to filter, to pressurize, elevate and streamline the air that flows through the nose. They provide most of the nasal mucosa for the air to flow over and by doing so they act as the radiators, the humidifiers and filters of the nose. The unique air-conditioning and processing conditions that the turbinates supply are not important only for proper lung function but also for keeping the health, function and integrity of the rest of the nasal mucosa, which is essentially the organ-system of the nose, as it covers all the inner nasal chambers and sinus cavities. The turbinates, in particularly the inferior ones, also play a crucial role in protecting the pharynx and larynx from the effect of direct insult of airflow and dryness.
The turbinates are also heavily innervated with pressure sensing receptors (of the trigeminal cranial nerve) that sense the airflow and thus notify the brain that enough air is traversing the nose to sustain life. If too much of these receptors are gone nasal breathing becomes unsatisfying, even though there is no structural blockage. This is called 'paradoxical obstruction' and is very common in ENS. This lack of airflow sensation causes much distress and morbidity to the sense of well being.
The turbinates, especially the inferior ones, also provide most of the nasal resistance to the lungs. The lungs need some resistance to allow them to reach their proper inflation and deflation rates during inhalation and exhalation. The nose supplies 50% of the entire resistance to the lungs. The turbinates supply most of these 50%. The function of nasal resistance is poorly researched and understood. It is well known from clinical observation that too little nasal resistance can cause similar pulmonary breathing difficulties and shortness of breath as too much resistance. Healthy nasal breathing is essential for maintaining all aspects of physical and mental health.
The turbinates also trap more than 75% of the water vapor returning from the lungs upon exhalation and thus help protect the body from dehydration.
The poorly understood naso-pulmonary reflex may also play a role in causing pulmonary restriction in ENS patients.