Impact of Septal Correction on the Blood Pressure of Hypertensive Patients with Deviated Nasal Septum

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• 作者：S. G. Smitha ; B. Jagannath…
• 关键词：Nasal septum ; Nasal obstruction ; Deviation ; Hypertension ; Blood pressure
• 刊名：Indian Journal of Otolaryngology and Head & Neck Surgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：68
• 期：1
• 页码：46-51
• 全文大小：478 KB
• 参考文献：1.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):119–121PubMed PubMedCentral
  2.Aziz T, Biron VL, Ansari K, Mir CF (2014) Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J otolaryngol Head Neck Surg 43(1):11CrossRef PubMed PubMedCentral
  3.Acar B, Yavuz B, Karabulut H, Gunbey E, Babademez MA, Yalcin AA et al (2010) Sympathetic overactivity in patients with nasal septum deformities. Eur Arch Otorhinolaryngol 267:73–76CrossRef PubMed
  4.Guilleminault C, Stoohs R, Shiomi T, Kushida C, Schnittger I (1995) Upper airway resistance syndrome, nocturnal blood pressure monitoring, and borderline hypertension. Chest 109(4):901–908CrossRef
  5.Moser KA, Agarwal 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 PubMed PubMedCentral
  6.Giles TD, Berk BC, Black HR, Cohn JN, Kostis JB et al (2005) Expanding the definition and classification of hypertension. J Clin Hypertens 7(9):505–512CrossRef
  7.Yuritas V, Ozturk S, Apuhan T, Demirhan A, Tekelioglu UY, Akkaya A et al (2014) Pre and postoperative evaluation of cardiac autonomic function in patients with nasal septum deviation. Acta Medica 30:149
  8.Poyhonen M, Syvaoja S, Hartikainen J et al (2004) The effect of carbon dioxide, respiratory rate and tidal volume on human heart rate variability. Acta Anaesthesiol Scand 48:93–101CrossRef PubMed
  9.Burnum JF, Hickam JB, McIntosh HD (1995) The effect of hypocapnia on arterial blood pressure. Circulation 9(1):89–95CrossRef
  10.Cho GS, Kim JH, Jang YJ (2012) Correlation of nasal obstruction with nasal cross-sectional area measured by computed tomography in patients with nasal septal deviation. Ann Otol Rhinol Laryngol 121(4):239–245CrossRef PubMed
  11.Kensei N, Philip C, Roman C et al (1988) Nasal resistance, sensation of obstruction and rhinoscopic findings compared. Am J Rhinology 2(2):65–69CrossRef
  12.Enache A, Lieder A, Issing W (2014) Nasal septoplasty with submucosal diathermy to inferior turbinate improves symptoms at 3 months postoperatively in a study of one hundred and one patients. Clin Otolaryngol 39(1):57–63CrossRef PubMed
  13.Nofal F, Thomas M (1990) Rhinomanometry evaluation of the effects of pre and postoperative SMR on exercise. J Laryngol Otol 104(2):126–128CrossRef PubMed
  14.Irfan M, Jihan W (2009) Submucosal diathermy for inferior turbinates hypertrophy—how long does it sustain? Int J Otorhinolaryngol 10(1):911–915
  15.Nakata S, Noda A, Yagi H, Yanagi E, Mimura T, Okada T et al (2005) Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnoea syndrome. Rhinology 44:296–299
  16.Cole P, Chaban R, Naito K, Oprysk D (1988) The Obstructive nasal septum: effect of simulated deviations on nasal airflow resistance. Arch Otolaryngol Head Neck Surg 114(4):410–412CrossRef PubMed
  17.Garcia GJM, Rhee JS, Senior BA, Kimbell JS et al (2010) Septal deviation and nasal resistance:an investigation using virtual surgery and computational fluid dynamics. Am J Rhinol Allergy 24(1):e46–e53CrossRef PubMed
  18.Stamler J, Berkson DM, Dyer A, Lepper MH, Lindberg HA, Paul O et al (1975) Relationship of multiple variables to blood pressure-findings from four Chicago epidemiologic studies. In: Epidemiology and control of hypertension, Miami, Symposia Specialists 307–356
  
• 作者单位：S. G. Smitha (1)
  B. Jagannath (1)
  Amrita Suzanne Mathew (1)
  
  1. Department of ENT, Kempegowda Institute of Medical Sciences, K.R Road, V.V Puram, Bangalore, 560004, Karnataka, India
  
• 刊物主题：Otorhinolaryngology; Head and Neck Surgery;
• 出版者：Springer India
• ISSN：0973-7707

文摘

This study aims to evaluate the effect of septal correction on the blood pressure (BP) of patients with symptomatic nasal septal deviation and to assess whether a positive association exists between deviated nasal septum and hypertension. A prospective observational clinical study was conducted at Kempegowda Institute of Medical Sciences, Bangalore. Hundred adults, aged 18–40 years, with symptomatic nasal septal deviation, newly detected untreated hypertension (mean BP ≥140/90 mmHg), undergoing submucosal resection of the septum and submucosal diathermy of hypertrophied inferior turbinate (when present), were included. Postoperative follow up for ENT examination and BP measurement was done at 1, 6 and 12 months. Seventy five males and 25 females met the inclusion criteria. 48 % were aged 31–35 years (mean = 31.83 ± 5.19 years). 71 % had anterior septal deviation, 13 % posterior deviation and 16 % a combination of both. Preoperatively, mean systolic blood pressure was 141.82 ± 1.70 mmHg and mean diastolic blood pressure was 91.04 ± 1.21 mmHg, which postoperatively decreased by 10–12 mmHg and 4–5 mmHg respectively. 79 % showed a significant (P < 0.001) decrease in BP postoperatively. 13 % showed no change in BP, of which 53.8 % had posterior deviation, demonstrating a significant association (P < 0.001) between type of deviation and response to surgery. In 8 %, a rise in BP over the follow up period was seen; of these, 62.5 % were aged 36–40 years, indicating a significant association (P < 0.001) between age and BP. Surgical correction of septal deviation is thus effective in controlling the BP of patients with anterior deviation, aged <35 years.