[3][5][6][7][8] The syndrome's existence as a distinct medical condition is controversial, with adoption by a growing body of ear, nose and throat (ENT) practitioners and plastic surgeons.

The authors hypothesize that the link between ENS and HVS could be explained by the nasal injury that occurs to the turbinates that alters the respiratory control system.

This reduced amount of mucus in the nose can also be attributed to the change in airflow often resulting in dry cool air hitting the back of the patient's throat.

[3] Investigators have been unable to identify consistent diagnostic or precipitating features, psychological causes leading to a psychosomatic condition have been proposed.

[3][5][9] As of 2015, protocols for using rhinomanometry to diagnose ENS and measure response to surgery were under development,[5][9] as was a standardized clinical instrument (a well defined and validated questionnaire) to obtain more useful reporting of symptoms.

[citation needed] For this reason it is critical that anyone planning any surgery to the nose for function or appearance should be aware of the high risk of ENS developing if the body does not accept the new airflow and exchange of gasses.

Initial treatment is similar to atrophic rhinitis, namely keeping the nasal mucosa moist with saline or oil-based lubricants and treating pain and infection as they arise; adding menthol to lubricants may be helpful in ENS, as may be use of a cool mist humidifier at home but has limited success and many ENT patients seek treatment from the few ENTs well educated in ENS surgical techniques.

A 2015 meta-analysis identified 128 people treated with surgery from eight studies that were useful to pool, with an age range of 18 to 64, most of whom had been experiencing ENS symptoms for many years.

The most common surgical approach was creating a pocket under the mucosa and implanting material - the amount and location were based on the judgement of the surgeon.

In about half the cases a filler such as noncellular dermis, a medical-grade porous high-density polyethylene, or silastic was used and in about 40% cartilage taken from the person or from a cow was used.

[9] Data measuring the prevalence of Empty Nose Syndrome (ENS) after turbinate surgery is limited to a few single surgeon studies with variable results.

Research on safety and efficacy of existing treatments is limited to a handful of published studies with a small number of participants and self-reported results from specialists treating this condition.

[9] As early as 1914, Dr Albert Mason reported cases of "a condition resembling atrophic rhinitis" with "a dryness of the nose and throat" following turbinectomy.

Mason called the turbinates "the most important organ in the nose" and claimed they were "slaughtered and removed with discriminate abandon more than any other part of the body, with the possible exception of the prepuce.

[3] Kern and Eric Moore published a case study of 242 people with secondary atrophic rhinitis in 2001 and were the first to attribute the cause to prior sinonasal surgery in the scientific literature.