INTRODUCTION: Nasal septum is the bone and cartilage of the nose that separates the nasal cavity into two passages the space between the septum and the lateral walls of the nasal cavity regulates airflow and respiration. Nasal septum deviation is one of the most frequent reasons for nasal obstruction presented with a reduction in nasal airflow and chronic mucosal irritation. Abnormal upper airway resistance can play a role in the development of hypertension. Effective management of hypertension decreases the risk of, myocardial infarction, stroke, chronic kidney disease and heart failure.
MATERIAL AND METHODS: Adults of both sexes with age range from 20–40 years, suffering from symptomatic nasal septal deviation and newly detected hypertension (mean BP ≥140/90 mm Hg), undergoing submucosal resection (SMR) of the deviated septum, were included in the study. Preoperative evaluation was done and detailed history was taken. asal septal deformities were classified according to the Dreher scale (0 = none i.e. no deviation, 1 = mild deviation i.e. deviation less than half of the total distance to the lateral wall, 2 = moderate deviation i.e. deviation greater than half of the total distance to the lateral wall but not touching it, 3 = severe deviation i.e. deviation touching the lateral wall). Compensatory inferior turbinate hypertrophy, when present, was noted. Hypertension was considered as controlled in patients who had a mean SBP <140 mm Hg and mean DBP <90 mm Hg on follow up, Patients in whom SBP was ≥140 mm Hg and/or DBP ≥90 mm Hg, were considered as uncontrolled hypertensive and they were started on medical treatment for hypertension. Postoperatively, patients were followed up after 1 month, 3 months and at the end of 1 year.
RESULTS: Of the 50 patients included in the study 40 (80%) were male and 10(20%) were female. Mean age was 34 ± 4.56. Mild septal deviation was seen in 10(20%), moderate septal deviation was observed in 31 (62%) and severe septal deviation was seen in 9 (18%). Compensatory hypertrophy was observed in 11(22%) of cases. Mean preoperative SBP was 143.76 ± 2.78 mm Hg and mean DBP was 93 ± 1.55 mm Hg. Hypertension was controlled in 70 % of patients who showed a strongly significant (P < 0.001) decrease in BP about 10–12 mm Hg decrease in SBP and 4–5 mm Hg decrease in DBP.
CONCLUSION: Patients with hypertension and deviated nasal septum, surgical correction is always indicated as it helps in reducing the blood pressure and thereby prevent cardio-pulmonary and cardio vascular complications secondary to hypertension.
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