There have been descriptions of atrophic rhinitis in both its primary and secondary forms, with the secondary form typically occurring as a result of surgical trauma, granulomatous inflammation, or irradiation. Nasal biopsy if performed reveals glandular atrophy, endarteritis obliterans, and inflammatory cell infiltration. Paradoxical congestion (sensation of nasal congestion or obstruction despite large nasal cavities), dryness, and crusting are features, much as in ENS. The dryness and crusting represent loss of glandular function and humidification of the inspired air. Atrophic rhinitis can be a crippling disease, and the patient can be disabled by the chronic, unrelenting nature of the symptoms and airflow limitation. Endoscopy reveals partial or total absence of the inferior and/or middle turbinate in many cases. Empty Nose Syndrome (ENS) is typically diagnosed after turbinectomy and can be further subdivided into three distinct subtypes. ENS einferior turbinate, also known as ENS-IT, is an ENS that is found after tissue from the IT has been resected. This is the most common subtype of the condition, and it is estimated that it will develop in 20% of patients who have IT surgery. estimates, on the other hand, put the incidence after IT surgery at 16%. In these patients, it has been hypothesised that the development of the syndrome was brought on by a combination of factors, including tissue resection brought on by surgery and inadequate nerve regeneration. Patients who suffer from refractory sinus headaches, patients who have malignant tumours, and sometimes even patients who are undergoing transsphenoidal pituitary surgery are all candidates for extensive turbinectomy. Nasal hygiene with regular intranasal irrigation remains the standard of conservative therapy by minimizing crusting and restoring nasal hydration. Medical treatment includes nasal lavage, topical ointment, antibiotic therapy, aerosols, and local corticosteroids, although such treatments seem to be less effective in ENS than in atrophic rhinitis. Adding menthol to the local treatments may be beneficial; however, its effect on the nasal patency is because of a sensory illusion rather than altered airflow. The aims of the endonasal surgery are to reduce nasal cavity volume, increase resistance to the airflow, reduce the airflow to increase air humidity, and deviate the airflow from the surgical site toward a healthy or a nonoperated side. The creation of a neoturbinate is the most common surgical solution for ENS. Techniques vary from team to team, but the results have been very encouraging. The principle consists of positioning an implant in a pocket in the septum, floor, or lateral wall of the nose. The location of the implant is based on the patient’s history, examination, computed tomography scan findings, and the results of the cotton test in the office. Patients who gain no benefit from the cotton test are deemed poor candidates for implantation.