Resumen: Atrophic rhinitis (or rhinosinusitis) (AR) is a complex syndrome associated with progressive atrophy of the nasal mucosa and underlying bone . It is a disease of debatable and often unproven etiology . Some consensus exists  around the general theory that it can originate either as a primary form (as discussed in previous chapters) that is mostly related to bacterial colonization  or as a secondary consequence of traumatic and inflammatory stimuli to the nasal mucosa. Both situations lead to a significant impairment in the quality of life of the patient . The purpose of this chapter is to conduct an in-depth exploration of the form of atrophic rhinitis that occurs after sinonasal surgical intervention. This type of atrophic rhinitis will be referred to as ¿empty nose syndrome¿ (ENS). Specific etiologies and epidemiology and proposed theories for pathophysiology will be discussed. Typical clinical manifestations, as well as features that are distinct from the primary form, will be reviewed. Finally, we seek to provide a guide for the diagnosis and management of this chronic pathology according to existing evidence in the literature.