atrophic rhinitis iatrogenic disease empty nose syndrome https://github.com/monarch-initiative/mondo/issues/9174 ENS MEDGEN:1876481 secondary atrophic rhinitis UMLS:C3888849 GARD:0028165 nasal iatrogenic dysfunction ENS is often misdiagnosed as psychiatric in origin due to the disproportionate suffering compared to physical exam findings. ENS results from disruption of normal nasal airflow dynamics, mucosal sensory feedback, and humidification, typically after aggressive surgical intervention on the nasal turbinates. Estimated prevalence: <1 in 10,000, though underreporting and misdiagnosis likely make this an underestimate. ENS is currently considered a rare, post-surgical complication, with cases reported globally but concentrated among ENT surgical patients. No universally accepted biomarker exists. Diagnosis is based on symptoms, medical history and imaging. There is no cure. Symptom management includes nasal moisturization (saline gels, humidification), nerve modulating agents (e.g., amitriptyline, gabapentin) nasal implants to restore airflow resistance and cognitive-behavioral therapy and psychiatric support. ENS most often develops after surgery and is considered an iatrogenic condition because its other causes also result from medical interventions, such as electrocautery or laser procedures that cause turbinate trauma. post-turbinectomy syndrome MONDO:1060148 A rare iatrogenic disease characterized by paradoxical nasal obstruction and symptoms including air hunger and suffocation-like breathing sensation, nasal dryness and crusting, burning pain or cold airflow sensation, impaired sleep and cognitive function and severe anxiety and depression, and typically occurs after surgical reduction or removal of nasal turbinates.