Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 2/2021

01-02-2021 | Rhinology

Does septoplasty affect 24-h ambulatory blood pressure measurements in patients with type 2 and 3 pure nasal septal deviation?

Authors: Deniz Avcı, Sabri Güler, Ayşegül Hartoka Sevinç

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2021

Login to get access

Abstract

Purpose

To investigate day, night and 24 h all blood pressure effects of septoplasty by comparing pre- and post-operative 24-h ambulatory blood pressure monitoring (ABPM) values of NSD patients undergoing septoplasty.

Materials and methods

The prospective study included 20 patients with type 2 and 3 pure NSD (mean age, 23.60 ± 6.51) who underwent septoplasty in our clinic. Nasal obstruction symptom evaluation (NOSE) questionnaire was applied to each participant both pre- and post-operatively to evaluate their views on the severity of NSD and the effectiveness of surgical outcomes. A comprehensive ABPM examination was performed both 2 days before surgery and at three months postoperatively for each patient and the findings were compared among patients.

Results

Preoperative NOSE score was 87.75 ± 7.34% and the postoperative score was 12.50 ± 6.58% (p = 0.000). Following septoplasty, 24-h systolic blood pressure (24SBP) declined from 119.4 ± 9.9 mmHg to 112.2 ± 8.0 mmHg (p = 0.000), daytime SBP (DSBP) declined from 125.9 ± 11.0 mmHg to 117.9 ± 8.4 mmHg (p = 0.000), nighttime SBP (NSBP) declined from 112.7 ± 9.5 mmHg to 105.5 ± 7.9 mmHg (p = 0.000), 24-h pulse pressure (24PP) declined from 46.7 ± 10.1 mmHg to 44.0 ± 8.4 mmHg (p = 0.015), and mean daytime PP (DPP) declined from 46.9 ± 9.7 mmHg to 44.6 ± 8.6 mmHg (p = 0.026).

Conclusion

The decline in NOSE percentages following septoplasty demonstrated that the satisfaction levels of the patients were increased. Upper airway obstruction secondary to NSD may affect ABPM measurements. Moreover, the significant decrease in the 24SBP, DSBP, NSBP, 24PP and DPP following septoplasty showed that NSD may cause cardiovascular risk and this risk may be prevented by septoplasty.
Literature
1.
go back to reference Neskey D, Eloy JA, Casiano RR (2009) Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am 42(2):193–205CrossRef Neskey D, Eloy JA, Casiano RR (2009) Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am 42(2):193–205CrossRef
2.
go back to reference Aziz T, Biron VL, Ansari K, Flores-Mir C (2014) Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg 43(1):11CrossRef Aziz T, Biron VL, Ansari K, Flores-Mir C (2014) Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg 43(1):11CrossRef
3.
go back to reference Most SP, Rudy SF (2017) Septoplasty: basic and advanced techniques. Facial Plast Surg Clin North Am 25(2):161–169CrossRef Most SP, Rudy SF (2017) Septoplasty: basic and advanced techniques. Facial Plast Surg Clin North Am 25(2):161–169CrossRef
4.
go back to reference Hassanpour SE, Moosavizadeh SM, Araghi MF, Eshraghi B (2014) Pulmonary artery pressure in patients with markedly deviated septum candidate for septorhinoplasty. World J Plast Surg 3(2):119–121PubMedPubMedCentral Hassanpour SE, Moosavizadeh SM, Araghi MF, Eshraghi B (2014) Pulmonary artery pressure in patients with markedly deviated septum candidate for septorhinoplasty. World J Plast Surg 3(2):119–121PubMedPubMedCentral
5.
go back to reference Smitha SG, Jagannath B, Mathew AS (2016) Impact of septal correction on the blood pressure of hypertensive patients with deviated nasal septum. Indian J Otolaryngol Head Neck Surg 68(1):46–51CrossRef Smitha SG, Jagannath B, Mathew AS (2016) Impact of septal correction on the blood pressure of hypertensive patients with deviated nasal septum. Indian J Otolaryngol Head Neck Surg 68(1):46–51CrossRef
6.
go back to reference Guilleminault C, Stoohs R, Shiomi T, Kushida C, Schnittger I (1996) Upper airway resistance syndrome, nocturnal blood pressure monitoring, and borderline hypertension. Chest 109(4):901–908CrossRef Guilleminault C, Stoohs R, Shiomi T, Kushida C, Schnittger I (1996) Upper airway resistance syndrome, nocturnal blood pressure monitoring, and borderline hypertension. Chest 109(4):901–908CrossRef
7.
go back to reference Coy TV, Dimsdale JE, Ancoli-Israel S, Clausen J (1996) Sleep apnoea and sympathetic nervous system activity: a review. J Sleep Res 5(1):42–50CrossRef Coy TV, Dimsdale JE, Ancoli-Israel S, Clausen J (1996) Sleep apnoea and sympathetic nervous system activity: a review. J Sleep Res 5(1):42–50CrossRef
8.
go back to reference Acar B, Yavuz B, Karabulut H, Gunbey E, Babademez MA, Yalcin AA et al (2010) Parasympathetic overactivity in patients with nasal septum deformities. Eur Arch Otorhinolaryngol 267(1):73–76CrossRef Acar B, Yavuz B, Karabulut H, Gunbey E, Babademez MA, Yalcin AA et al (2010) Parasympathetic overactivity in patients with nasal septum deformities. Eur Arch Otorhinolaryngol 267(1):73–76CrossRef
9.
go back to reference Yurttas V, Ozturk S, Apuhan T, Demirhan A, Tekelioglu ÜY, Akkaya A et al (2014) Pre and postoperative evaluation of cardiac autonomic function in patients with nasal septum deviation. Acta Med Mediterranea 30:149–153 Yurttas V, Ozturk S, Apuhan T, Demirhan A, Tekelioglu ÜY, Akkaya A et al (2014) Pre and postoperative evaluation of cardiac autonomic function in patients with nasal septum deviation. Acta Med Mediterranea 30:149–153
10.
go back to reference Hsu WC, Kang KT, Chiu SN, Weng WC, Lee PL, Lin CY (2018) 24-Hour ambulatory blood pressure after adenotonsillectomy in childhood sleep Apnea. J Pediatr 199:112–117CrossRef Hsu WC, Kang KT, Chiu SN, Weng WC, Lee PL, Lin CY (2018) 24-Hour ambulatory blood pressure after adenotonsillectomy in childhood sleep Apnea. J Pediatr 199:112–117CrossRef
11.
go back to reference Dreher A, de la Chaux R, Klemens C, Werner R, Baker F, Barthlen G et al (2005) Correlation between otorhinolaryngologic evaluation and severity of obstructive sleep Apnea syndrome in snorers. Arch Otolaryngol Head Neck Surg 131(2):95–98CrossRef Dreher A, de la Chaux R, Klemens C, Werner R, Baker F, Barthlen G et al (2005) Correlation between otorhinolaryngologic evaluation and severity of obstructive sleep Apnea syndrome in snorers. Arch Otolaryngol Head Neck Surg 131(2):95–98CrossRef
12.
go back to reference Onerci Celebi O, Araz Server E, Yigit O, Longur ES (2018) Adaptation and validation of the Turkish Version of the Nasal obstruction symptom evaluation scale. Int Forum Allergy Rhinol 8(1):72–76CrossRef Onerci Celebi O, Araz Server E, Yigit O, Longur ES (2018) Adaptation and validation of the Turkish Version of the Nasal obstruction symptom evaluation scale. Int Forum Allergy Rhinol 8(1):72–76CrossRef
13.
go back to reference André RF, Vuyk HD, Ahmed A, Graamans K, Nolst Trenité GJ (2009) Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol 34(6):518–525CrossRef André RF, Vuyk HD, Ahmed A, Graamans K, Nolst Trenité GJ (2009) Correlation between subjective and objective evaluation of the nasal airway. A systematic review of the highest level of evidence. Clin Otolaryngol 34(6):518–525CrossRef
14.
go back to reference Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G (2005) Long term results following nasal septal surgery focus on patients’ satisfaction. Auris Nasus Larynx 32(4):369–374CrossRef Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G (2005) Long term results following nasal septal surgery focus on patients’ satisfaction. Auris Nasus Larynx 32(4):369–374CrossRef
15.
go back to reference O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G et al (2013) European society of hypertension position paper on ambulatory blood pressure monitoring. J Hypertens 31(9):1731–1768CrossRef O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G et al (2013) European society of hypertension position paper on ambulatory blood pressure monitoring. J Hypertens 31(9):1731–1768CrossRef
16.
go back to reference Güzelküçük Akay H, Bayar Muluk N, Inal M, Şimşek G, Kiliç R (2019) Evaluation of olfactory sensation, acoustic rhinometry, and quality of life of the patients with nasal septal deviation. J Craniofac Surg 30(4):1221–1227CrossRef Güzelküçük Akay H, Bayar Muluk N, Inal M, Şimşek G, Kiliç R (2019) Evaluation of olfactory sensation, acoustic rhinometry, and quality of life of the patients with nasal septal deviation. J Craniofac Surg 30(4):1221–1227CrossRef
17.
go back to reference Smith KD, Edwards PC, Saini TS, Norton NS (2010) The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010:404982CrossRef Smith KD, Edwards PC, Saini TS, Norton NS (2010) The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010:404982CrossRef
18.
go back to reference Derin S, Akın F, Şahan M, Altun İ, Şahin C, Eliçora SŞ (2015) Impact of markedly nasal septal deviation on 24-hour rhythm holter findings. Kulak Burun Bogaz Ihtis Derg 25(5):284–288CrossRef Derin S, Akın F, Şahan M, Altun İ, Şahin C, Eliçora SŞ (2015) Impact of markedly nasal septal deviation on 24-hour rhythm holter findings. Kulak Burun Bogaz Ihtis Derg 25(5):284–288CrossRef
19.
go back to reference Yılmaz MD, Onrat E, Altuntaş A, Kaya D, Kahveci O, Dereköy S et al (2004) The effects of nasal packs on systemic blood pressure after septoplasty. KBB-Forum 3(4):122–125 Yılmaz MD, Onrat E, Altuntaş A, Kaya D, Kahveci O, Dereköy S et al (2004) The effects of nasal packs on systemic blood pressure after septoplasty. KBB-Forum 3(4):122–125
20.
go back to reference Celiker M, Cicek Y, Tezi S, Ozgur A, Polat HB, Dursun E (2018) Effect of septoplasty on the heart rate variability in patients with nasal septum deviation. J Craniofac Surg 29(2):445–448CrossRef Celiker M, Cicek Y, Tezi S, Ozgur A, Polat HB, Dursun E (2018) Effect of septoplasty on the heart rate variability in patients with nasal septum deviation. J Craniofac Surg 29(2):445–448CrossRef
21.
go back to reference Pedersen L, Schiöler L, Holmberg K, Emanuelsson CA, Hellgren J (2018) Age and unplanned postoperative visits predict outcome after septoplasty: a National Swedish register study. Int J Otolaryngol 2018:2379536CrossRef Pedersen L, Schiöler L, Holmberg K, Emanuelsson CA, Hellgren J (2018) Age and unplanned postoperative visits predict outcome after septoplasty: a National Swedish register study. Int J Otolaryngol 2018:2379536CrossRef
22.
go back to reference Fidan V, Aksakal E (2011) Impact of septoplasty on pulmonary artery pressure in patients with markedly deviated septum. J Craniofac Surg 22(5):1591–1593CrossRef Fidan V, Aksakal E (2011) Impact of septoplasty on pulmonary artery pressure in patients with markedly deviated septum. J Craniofac Surg 22(5):1591–1593CrossRef
23.
go back to reference Hansen TW, Kikuya M, Thijs L, Björklund-Bodegard K, Kuznetsova T, Ohkubo T et al (2007) Prognostic superiority of daytime ambulatory over conventional blood pressure in four populations: a meta-analysis of 7,030 individuals. J Hypertens 25(8):1554–1564CrossRef Hansen TW, Kikuya M, Thijs L, Björklund-Bodegard K, Kuznetsova T, Ohkubo T et al (2007) Prognostic superiority of daytime ambulatory over conventional blood pressure in four populations: a meta-analysis of 7,030 individuals. J Hypertens 25(8):1554–1564CrossRef
24.
go back to reference Angeli F, Reboldi G, Poltronieri C, Bartolini C, D'Ambrosio C, de Filippo V et al (2014) Clinical utility of ambulatory blood pressure monitoring in the management of hypertension. Expert Rev Cardiovasc Ther 12(5):623–634CrossRef Angeli F, Reboldi G, Poltronieri C, Bartolini C, D'Ambrosio C, de Filippo V et al (2014) Clinical utility of ambulatory blood pressure monitoring in the management of hypertension. Expert Rev Cardiovasc Ther 12(5):623–634CrossRef
25.
go back to reference Hao G, Wang X, Treiber FA, Harshfield G, Kapuku G, Su S (2017) Blood pressure trajectories from childhood to young adulthood associated with cardiovascular risk: results from the 23-year longitudinal georgia stress and heart study. Hypertension 69(3):435–442CrossRef Hao G, Wang X, Treiber FA, Harshfield G, Kapuku G, Su S (2017) Blood pressure trajectories from childhood to young adulthood associated with cardiovascular risk: results from the 23-year longitudinal georgia stress and heart study. Hypertension 69(3):435–442CrossRef
26.
go back to reference D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM et al (2008) General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation 117(6):743–753CrossRef D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM et al (2008) General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation 117(6):743–753CrossRef
27.
go back to reference Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G et al (2003) Estimation of 10-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24(11):987–1003CrossRef Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G et al (2003) Estimation of 10-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24(11):987–1003CrossRef
28.
go back to reference Moser KA, Agrawal S, Smith GD, Ebrahim S (2014) Socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in India: analysis of nationally representative survey data. PLoS ONE 9(1):e86043CrossRef Moser KA, Agrawal S, Smith GD, Ebrahim S (2014) Socio-demographic inequalities in the prevalence, diagnosis and management of hypertension in India: analysis of nationally representative survey data. PLoS ONE 9(1):e86043CrossRef
29.
go back to reference Benetos A, Safar M, Rudnichi A, Smulyan H, Richard JL, Ducimetieere P et al (1997) Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension 30(6):1410–1415CrossRef Benetos A, Safar M, Rudnichi A, Smulyan H, Richard JL, Ducimetieere P et al (1997) Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension 30(6):1410–1415CrossRef
30.
go back to reference Franklin SS, Khan SA, Wong ND, Larson MG, Levy D (1999) Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham Heart Study Circ 100(4):354–360CrossRef Franklin SS, Khan SA, Wong ND, Larson MG, Levy D (1999) Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham Heart Study Circ 100(4):354–360CrossRef
31.
go back to reference Goldberg RJ, Larson M, Levy D (1996) Factors associated with survival to 75 years of age in middle-aged men and women. Framingham Study Arch Intern Med 156(5):505–509CrossRef Goldberg RJ, Larson M, Levy D (1996) Factors associated with survival to 75 years of age in middle-aged men and women. Framingham Study Arch Intern Med 156(5):505–509CrossRef
Metadata
Title
Does septoplasty affect 24-h ambulatory blood pressure measurements in patients with type 2 and 3 pure nasal septal deviation?
Authors
Deniz Avcı
Sabri Güler
Ayşegül Hartoka Sevinç
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 2/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-020-06288-x

Other articles of this Issue 2/2021

European Archives of Oto-Rhino-Laryngology 2/2021 Go to the issue