The effect of septoplasty on pulmonary artery pressure and right ventricular function in nasal septum deviation

Abstract

Nasal septum deviation (NSD) can cause obstruction of the upper airway, which may lead to increased pulmonary artery pressure (PAP) and right ventricle dysfunction. The aim of the present study was to evaluate the effect of septoplasty on right ventricular function and mean PAP of patients with marked NSD. 25 patients with marked NSD (mean age = 31.8 ± 12.3 years) and 27 healthy volunteers (mean age = 34.5 ± 10.8 years) were enrolled. Echocardiography was performed for all subjects and right ventricular function and mean PAP were evaluated before and 3 months after septoplasty. Tricuspid annular plane systolic excursion (TAPSE) and tricuspid annulus early diastolic myocardial velocity (E') were significantly lower in patients with NSD than control subjects, while right ventricle myocardial performance index (RVMPI) and mean PAP were significantly higher (respectively, p = 0.006, 0.037, 0.049, 0.046). When preoperative and postoperative findings were compared, the mean PAP decreased whereas TAPSE increased significantly (respectively, p = 0.007, 0.03). The results of the present study demonstrated that mean PAP increased and right ventricular function worsened in patients with NSD. However, mean PAP decreased and right ventricular function tended to recover after septoplasty.

Effect of septoplasty on functional outcomes and physical fitness level

“…They showed that patients with NSD had increased PAB levels and impaired function of the right ventricle compared with the healthy subjects. Moreover, the impaired outcomes improved after septoplasty (8).…”

The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps

“…In previous studies, it was shown that RV functions recovered and pulmonary artery pressure decreased significantly after surgical correction of upper airway obstruction in patients with adenotonsillar hypertrophy, nasal septum deviation and similar pathologies. [9][10][11][12] To the best of our knowledge, this is the first study in the English literature in which patients operated on for severe NP were evaluated in terms of RV function in the postoperative period.…”

“…Pulmonary hypertension increases RV pressure and causes RV hypertrophy, dilatation and finally, RV dysfunction. [12][13][14] There is usually a long asymptomatic period until RV dysfunction develops. [13] When the patient becomes symptomatic, the process is mostly irreversible.…”

A prediction modeling based on SNOT-22 score for endoscopic nasal septoplasty: a retrospective study

“…NSD is an expensive medical condition, and also acts as a predisposing factor for other diseases ( Bousquet et al, 2008 ; Fokkens et al, 2012 ). For instance, long-term NSD may indirectly increase the risk of cardiovascular disease ( Ozkececi et al, 2016 ; Uluyol et al, 2016 ). Conservative treatments for NSD have a low benefit likelihood ( Lindsay, 2012 ; Rhee et al, 2014 ; Rudy & Most, 2017 ), and according to studies published in The Lancet in 2019, nasal septoplasty is more effective than non-surgical treatment in adults with NSD ( Van Egmond et al., 2019 ).…”