Arslan Hasan Huseyin, Aparci Mustafa, Arslan Zekeriya, Ozturk Cengiz, Isilak Zafer, Balta Sevket, Celik Turgay, Iyisoy Atila
Department of Otolaryngology, Etimesgut Military Hospital, Ankara, Turkey.
Eur Arch Otorhinolaryngol. 2015 Jul;272(7):1667-71. doi: 10.1007/s00405-014-3243-8. Epub 2014 Aug 17.
Any abnormality of collagen may affect the tissues with higher collagen content, e.g., joints, heart valves, and great arteries. Mitral valve prolapse (MVP) is a characteristic of generalized collagen abnormality. Nasal septum (NS) is constituted by osseous and cartilaginous septums that are highly rich in collagen. We evaluated the co-existence of deviation of NS (DNS) in patients with MVP. We retrospectively evaluated the recordings of echocardiographic and nasal examinations of subjects with MVP and DNS. We analyzed the features of MVP and anatomical classification of DNS among subjects. Totally, 74 patients with DNS and 38 subjects with normal nasal passage were enrolled to the study. Presence of MVP was significantly higher in patients with DNS compared to normal subjects (63 vs 26%, p < 0.001). Prolapse of anterior, posterior and both leaflets was higher in patients with DNS. Thickness of anterior mitral leaflet was significantly increased in patients with DNS (3.57 ± 0.68 vs 4.59 ± 1.1 mm, p < 0.001) compared to normal subjects. Type I, II, and III, IV DNS were higher in frequency in patients with MVP while type V and VI were higher in normal subjects. DNS is highly co-existent with MVP and increased thickness of mitral anterior leaflet. Generalized abnormality of collagen which is the main component of mitral valves and nasal septum may be accounted for co-existence of MVP and DNS. Also co-existence of them may exaggerate the symptoms of patients with MVP due to limited airflow through the nasal passage.
任何胶原蛋白异常都可能影响胶原蛋白含量较高的组织，如关节、心脏瓣膜和大动脉。二尖瓣脱垂（MVP）是全身性胶原蛋白异常的一个特征。鼻中隔（NS）由富含胶原蛋白的骨性和软骨性鼻中隔组成。我们评估了MVP患者鼻中隔偏曲（DNS）的共存情况。我们回顾性评估了MVP和DNS患者的超声心动图和鼻腔检查记录。我们分析了受试者中MVP的特征和DNS的解剖学分类。总共74例DNS患者和38例鼻腔通畅的受试者被纳入研究。与正常受试者相比，DNS患者中MVP的存在显著更高（63%对26%，p<0.001）。DNS患者中前叶、后叶及双叶脱垂的比例更高。与正常受试者相比，DNS患者二尖瓣前叶厚度显著增加（3.57±0.68对4.59±1.1mm，p<0.001）。I型、II型以及III型、IV型DNS在MVP患者中出现频率更高，而V型和VI型在正常受试者中出现频率更高。DNS与MVP以及二尖瓣前叶厚度增加高度共存。二尖瓣和鼻中隔的主要成分胶原蛋白的全身性异常可能是MVP和DNS共存的原因。它们的共存也可能由于鼻腔气流受限而加重MVP患者的症状。
