PRE-AND POSTOPERATIVE EVALUATION OF CARDIAC AUTONOMIC FUNCTION IN PATIENTS WITH NASAL SEPTUM DEVIATION

Aim: One of the most common causes of upper airway obstruction (UAO) is nasal septum deviation (NSD). Previous studies showed a strong association between UAO and impaired cardiac autonomic functions (CAF). The aim of this study was to evaluate changes in CAF during the pre- and post-operative periods in patients with NSD, using heart rate variability (HRV) parameters. Method: A total of 27 patients (13 males and 14 females; mean age 33 8 years) with NSD were included in the study. The electrocardiograms (ECG) and 24-h rhythm Holter monitoring analyses of all patients were evaluated pre-operatively, and 3 months post-operation, and daytime, nighttime, and combined data were assessed separately. The frequency of arrhythmias and HRV data were evaluated, and pre- and post-operative data were compared. Results: Although statistically non-significant, the frequency of atrial and ventricular premature heartbeats decreased, and the combined and daytime HRV data (including standard deviation of all NN intervals (SDNN), the mean of the standard deviations of all filtered R-R intervals for all 5-min segments of the analysis (SDNNi), standard deviation of the mean of NN intervals in all 5-min segments of the entire recording (SDANN), the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD), and the number of pairs of adjacent NN intervals differing by more than 50 ins divided by the total number of all NN intervals (pNN50)) increased in the post-operative compared with the pre-operative period (p>0.05). However, the mean heart rate was decreased significantly, and HRV nighttime analyses demonstrated an increase in post-operative PNN50 and RMSSD values compared with pre-operative ones (p=0.038 and p=0.041, respectively). Conclusion: Some of the HRV parameters changed significantly during the post-operative period in patients with NSD. This suggests that the operation may have positive effects on CAF. ECG and 24-h rhythm Holter monitoring may therefore be useful for evaluating the presence of arrhytlimias and CAF in patients with NSD during the pre-operative period.