The diagnosis is often Complicated.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

The diagnosis is often complicated because it is common to find that the remaining tissues are hypertrophied (in response to the dryness and constant aggravation of over-turbulent air currents).

The nasal cavity should look abnormally Spacious.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

On examination the nasal cavity should look abnormally spacious, lacking (part of) one or both turbinates (the inferior and/or middle turbinates). Mucosal pathology varies greatly. In some patients, the mucosa is dry and pale because of metaplasia; in others, it is red because of chronic infection. Crusting may range from absent to severe. The symptoms and findings are believed to be caused by abnormal aerodynamics, chronic inflammation and dryness leading to loss of airflow sensation that feels like dyspnea.

Diagnosis.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

The clinician should suspect ENS when the following findings are present: The patient complains of poor nasal breathing and often a relentless sensation of suffocation or shortness of breath despite having a patent (typically over-patent) nasal airway. The patients typically complain of nasal dryness too. These symptoms appeared only after the patient underwent a turbinate reductive procedure. Sometimes, many years later.

ENS symptoms are often felt by patients soon after Turbinectomy Procedures.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

This can take many years to fully develop, which may complicate the proper diagnosis. ENS is sometimes seen in patients who have lost relatively little of their turbinate tissue and whose turbinates appear to be almost normal in size; this is especially true in cases of anterior inferior turbinate (IT) resection because of its important role in the internal nasal valve.ENS symptoms are often felt by patients soon after turbinectomy procedures.

Squamous Metaplasia.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

Squamous metaplasia of nasal respiratory Epithelium.

The loss of too much Turbinate Tissue.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

The loss of too much turbinate tissue may cause the remaining mucosa at the vicinity of the site of resection, and directly behind and above that area, to gradually become more and more inflamed, dry, go through metaplasia, endertitis and eventually atrophy. As a result all four major functions of the nose become impaired:breathing, defense, olfaction, and phonology.

The loss of the Middle Turbinates.

http://en.wikipedia.org/wiki/Empty_nose_syndrome

Their loss will play a lesser role in the overall reduction of the retained heat and humidity in the nose, but it might impact the quality of the sense of smell and the health of the ethmoid and frontal sinuses. The superior turbinates are tiny in comparison to the inferior and middle ones and have the sole role of being the last line of protection around the olfactory bulb.