Background: A lot of materials have been used to reconstruct the Empty Nose Syndrome (ENS) patient's deficient anatomy including autografts (cartilage, bone, and fat), and allograft (alloderm). This work aimed for comparing the clinical outcomes, and the safety of using fat and cartilage implant in the treatment of ENS.

Patients and methods: We performed this randomized clinical trial on 24 patients with ENS and they were divided into 2 equal groups based on management: Group (I): Twelve patients who undergone fat implant and Group (II): Twelve patients who undergone cartilage implant. Assessment of nasal obstruction improvement, nasal crust, nasal depression and nasal dryness, olfactory sensation, and saccharine test were done among the both studied groups.

Results: There were significantly higher percent improvements of nasal obstruction, nasal crust, nasal depression, nasal dryness, olfactory sensation, mucociliary clearance improvement “Saccharine test" and endoscopic assessment, and Computed Tomography (CT) to nasal cavity in cartilage implant group compared to fat implant group within six months post operative (p=0.027, 0.005, 0.009, 0.009, 0.009, 0.004, <0.001, and 0.006 respectively).

Conclusion: Autologous cartilage can be used as an effective implant material for the treatment of Empty Nose Syndrome. Results from treatments including cartilage implants were more favorable. Endonasal microplastic implants for the treatment of ENS patients may benefit more from cartilage implants than fat implants