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on 24.02.2021 with the decision number 2017-KAEK-189_2021.02.24_04. All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Conflict of InterestNo conflict of interest was declared by the authors.

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This study was approved by the Institutional Review Board of the Yozgat Bozok University (2017-KAEK-189_2021.02.10_21). All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments.

Background: It is known that nasal septal deviation (NSD) has negative effects on the cardiovascular system, but the possible pathophysiological mechanisms of these effects still need to be explained. The aim of this study was to investigate the endothelial dysfunction (ED) caused by NSD and the effects of septoplasty on it. Methods: The study included 40 patients between the ages of 18 to 50 years with a marked NSD indication for septoplasty and 40 healthy age-and gender-matched individuals. Nasal obstruction symptom evaluation scale was used to evaluate the severity of nasal obstruction and the effectiveness of septoplasty. All participants underwent detailed cardiac examination and ultrasonographic measurement of flow-mediated dilatation (FMD). The same cardiac evaluations and nasal obstruction symptom evaluation scale assessments were repeated in the patient group at the postoperative 3rd month.Results: The mean FMD value in the control group was significantly higher than preoperative FMD in the patient group (9.1 AE 2.9 versus 7.6 AE 2.4, P ¼ 0.024). In the patient group, preoperative and postoperative FMD values were measured as 7.6 AE 2.4 and 9.0 AE 2.7, respectively, and there was a significant difference between them (P ¼ 0.032). There was no significant difference in FMD values between the control group and postoperative patient group (P ¼ 0.925). Conclusions: This study shows that NSD can cause ED, which is a precursor of atherosclerosis, and that successful septoplasty can improve ED.