Sahin Murat Sertan, Ozmen Omer Afsin, Yalcin Muhammed Ulvi
*Department of Otolaryngology, Hakkari State Hospital, Hakkari †Department of Otolaryngology, University of Uludag, Bursa ‡Department of Cardiology, Hakkari State Hospital, Hakkari, Turkey.
J Craniofac Surg. 2017 Oct;28(7):1803-1805. doi: 10.1097/SCS.0000000000003814.
The authors aimed to determine pulmonary artery pressure and right heart functions in patients with nasal septum deviation (NSD) with echocardiography (EchoCG) and compare the postoperative changes of EchoCG parameters with preoperative findings.
Seventy-six patients who underwent septoplasty composed the study group. Average age of patients was 23.50 ranging between 18 and 48 years of age. There were 53 males (69.7%) and 23 females (30.3%). Mean pulmonary artery pressure, tricuspid annular-plane systolic excursion, right ventricular diameter, and e/a ratio were measured by EchoCG preoperatively and same parameters were reobtained 3 months after surgery.
Mean pulmonary artery pressure reduced from 23.88 ± 6.36 to 19.80 ±3.95 mm Hg and tricuspid annular-plane systolic excursion increased from 22.36 ±3.85 to 23.57±3.00 3 months after surgery. It represented statistically significant improvement at right heart functions postoperatively (P < 0.001). Although they were not statistically significant, there was also some improvement in right ventricular diameter and e/a ratio values postoperatively.
Nasal septum deviation was associated with higher PAP values, which were improved after surgery. Although at a lower extent, a negative effect of NSD on right heart functions was also suspected. Thus, treatment of NSD without delay was proposed, not only to treat the nasal symptoms but possible future cardiovascular complications as well.
作者旨在通过超声心动图（EchoCG）测定鼻中隔偏曲（NSD）患者的肺动脉压和右心功能，并比较术后EchoCG参数与术前结果的变化。
76例行鼻中隔成形术的患者组成研究组。患者平均年龄23.50岁，年龄范围在18至48岁之间。其中男性53例（69.7%），女性23例（30.3%）。术前通过EchoCG测量平均肺动脉压、三尖瓣环平面收缩期位移、右心室直径和e/a比值，术后3个月再次测量相同参数。
术后3个月，平均肺动脉压从23.88±6.36降至19.80±3.95 mmHg，三尖瓣环平面收缩期位移从22.36±3.85增加至23.57±3.00。术后右心功能有统计学意义的改善（P<0.001）。虽然术后右心室直径和e/a比值的改善无统计学意义，但也有一定程度的改善。
鼻中隔偏曲与较高的肺动脉压值相关，术后肺动脉压值有所改善。虽然程度较轻，但也怀疑NSD对右心功能有负面影响。因此，建议及时治疗NSD，不仅是为了治疗鼻部症状，也是为了预防未来可能出现的心血管并发症。
