The Effects of Nasal Septum Deviation on Ocular Examination Findings: Does Deviated Nasal Septum Cause Impaired Vision?

Year 2022, Volume: 24 Issue: 1, 39 - 43, 30.04.2022

Fatih Alper Akcan Kuddusi Teberik Abdullah Belada İlhan Ünlü Yusuf Dündar

https://doi.org/10.18678/dtfd.1035995

Abstract

Aim: Nasal obstruction due to nasal septum deviation is associated with systemic diseases such as cardiopulmonary disease, neurological and vascular problems. But the effect of pure nasal deviation on the ocular system has not been precisely investigated. The aim of this study was to analyze the association of nasal septal deviation with ocular examination findings.
Material and Methods: Twenty-seven adult patients underwent septoplasty and 31 controls were included in the study. The study group was conducted on patients with pure nasal septum deviation which is significantly obstructing the nasal airway (>50%). In ophthalmological examination; peripapillary retinal nerve fiber layer, macular and choroidal thickness measurements were obtained. The examination findings were compared between the study and control groups.
Results: The mean macular thicknesses at nasal-500μm were 305.89±32.79 and 287.87±25.00 in the study and control groups, respectively (p=0.021). The mean macular thicknesses at nasal-1000μm were 353.04±21.28 and 341.16±17.97 in the study and control groups, respectively (p=0.025). The mean thickness of choroid was statistically significantly different at central (p=0.036) and peripheral measurements; nasal-500μm (p=0.020); nasal-1000μm (p=0.001); nasal-1500μm (p<0.001); temporal-500μm (p=0.023) and temporal-1000μm (p=0.045). No statistically significant difference was found between the two groups according to ocular tension, thickness of cornea, keratometry, anterior chamber depth, axial length of cornea, and retinal nerve fiber layer thickness.
Conclusion: This is one of the pioneer studies evaluating the ocular examination findings in patients with nasal septum deviation. Our results indicate the increased thickness of both macula and choroid in patients with nasal septum deviation.

Keywords

nasal septum deviation,, macular thickness, choroid thickness, ocular asymmetry

Nazal Septum Deviasyonunun Göz Muayenesi Bulgularına Etkileri: Nazal Septum Deviasyonu Görme Bozukluğuna Sebep Olur mu?

Abstract

Amaç: Nazal septum deviasyonuna bağlı burun tıkanıklığı, kardiyopulmoner hastalık, nörolojik ve vasküler problemler gibi sistemik hastalıklar ile ilişkilidir. Ancak saf nazal deviasyonun oküler sistem üzerindeki etkisi tam olarak araştırılmamıştır. Bu çalışmanın amacı nazal septal deviasyonun oküler muayene bulguları ile ilişkisini incelemektir.
Gereç ve Yöntemler: Bu çalışmaya septoplasti yapılmış olan 27 yetişkin hasta ve 31 kontrol dahil edildi. Çalışma grubu nazal hava yolunda ciddi bir şekilde tıkanıklık (>50%) oluşturan sadece nazal septum deviasyonlu hastalar ile oluşturuldu. Göz muayenesinde; perifer retina sinir lifi tabakası, makuler ve koroid kalınlık ölçümleri elde edildi. Muayene bulguları çalışma ve kontrol grupları arasında karşılaştırıldı.
Bulgular: Çalışma ve kontrol gruplarında nazal-500μm'deki ortalama makula kalınlıkları sırasıyla 305,89±32,79 ve 287,87±25,00 idi (p=0,021). Nazal-1000μm'deki ortalama makula kalınlıkları çalışma ve kontrol gruplarında sırasıyla 353,04±21,28 ve 341,16±17,97 idi (p=0,025). Ortalama koroid kalınlığı santral (p=0,036) ve periferal ölçümlerde; nasal-500μm (p=0,020), nazal-1000μm (p=0,001), nasal-1500μm (p<0,001), temporal-500μm (p=0,023) ve temporal-1000μm (p=0,045) istatistiksel olarak anlamlı şekilde farklıydı. Oküler tansiyon, kornea kalınlığı, keratometri, ön kamara derinliği, kornea aksiyel uzunluğu ve retina sinir lifi tabakası kalınlığı açısından iki grup arasında istatistiksel olarak anlamlı bir farklılık bulunmadı.
Sonuç: Bu çalışma nazal septum deviasyonu olan hastalarda oküler muayene bulgularını değerlendiren öncü çalışmalardan biridir. Sonuçlarımız, nazal septum deviasyonu olan hastalarda hem makula hem de koroid kalınlığının arttığını göstermektedir.

Keywords

nazal septum devaisyonu, makuler kalınlık, koroid kalınlık, oküler asimetri

References

• Stewart MG, Smith TL, Weaver EM, Witsell DL, Yueh B, Hannley MT, et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngol Head Neck Surg. 2004;130(3)0:283-90.
• Fettman N, Sanford T, Sindwani R. Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin North Am. 2009;42(2):241-52.
• Pérez-Piñas, Sabaté J, Carmona A, Catalina-Herrera CJ, Jiménez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197(Pt 2):221-7.
• Hassanpour SE, Moosavizadeh SM, Fadaei Araghi M, Eshraghi B. Pulmonary artery pressure in patients with markedly deviated septum candidate for septorhinoplasty. World J Plast Surg. 2014;3(2):119-21.
• Yonker AJ, Spaur RC. Upper airway obstruction and the pharyngeal lymphoid tissue. Otolaryngol Clin North Am. 1987;20(2):235-9.
• Gray LP. Deviated nasal septum. Incidence and etiology. Ann Otol Rhinol Laryngol Suppl. 1978;87(3 Pt 3 Suppl 50):3-20.
• Acar B, Yavuz B, Karabulut H, Gunbey E, Babademez MA, Yalcin AA, et al. Parasympathetic overactivity in patients with nasal septum deformities. Eur Arch Otorhinolaryngol. 2010;267(1):73-6.
• Cook TA, Komorn RM. Statistical analysis of the alteration of blood gases produced by nasal packing. Laryngoscope. 1973;83(11):1802-9.
• Chaitanya A, Pai VH, Mohapatra AK, Ve RS. Glaucoma and its association with obstructive sleep apnea: A narrative review. Oman J Ophthalmol. 2016;9(3):125-34.
• Ugurlu E, Pekel G, Altinisik G, Bozkurt K, Can I, Evyapan F. New aspect for systemic effects of COPD: eye findings. Clin Respir J. 2018;12(1):247-52.
• Şahin E, Songur MS, Kantekin Y, Bayhan HA, Can IH. Effect of deviated nasal septum on choroidal thickness. J Craniofac Surg. 2020;31(5):e439-42.
• Karataş M, Taşolar H. The effect of marked nasal septal deviation on left ventricular function and blood markers. J Craniofac Surg. 2019;30(3):803-7.
• Low WK, Willatt DJ. Headaches associated with nasal obstruction due to deviated nasal septum. Headache. 1995;35(7):404-6.
• Potsic WP, Pasquariello PS, Baranak CC, Marsh RR, Miller LM. Relief of upper airway obstruction by adenotonsillectomy. Otolaryngol Head Neck Surg. 1986;94(4):476-80.
• Kurkcuoglu S, Titiz A, Olcay I, Ozcan M, Tuncel U, Unal A. [Effect of nasal septal deviation on respiratory function tests and arterial blood gases]. Journal of Ear Nose Throat and Head Neck Surgery. 2007;15(3):134-8. Turkish.
• Bulcun E, Kazkayasi M, Ekici MA, Tahran FD, Ekici M. Effects of septoplasty on pulmonary function tests in patients with nasal septal deviation. J Otolaryngol Head Neck Surg. 2010;39(2):196-202.
• Yurttas V, Ozturk S, Apuhan T, Demirhan A, Tekelioglu UY, Akkaya A, et al. Pre and postoperative evaluation of cardiac autonomic function in patients with nasal septum deviation. Acta Medica Mediterr. 2014;30(1):149-53.
• Fidan V, Aksakal E. Impact of septoplasty on pulmonary artery pressure in patients with markedly deviated septum. J Craniofac Surg. 2011;22(5):1591-3.
• Koseoglu HI, Kanbay A, Ortak H, Karadag R, Demir O, Demir S, et al. Effect of obstructive sleep apnea syndrome on corneal thickness. Int Ophthalmol. 2016;36(3):327-33.
• Barceló A, Elorza MA, Barbé F, Santos C, Mayoralas LR, Agusti AG. Angiotensin converting enzyme in patients with sleep apnoea syndrome: plasma activity and gene polymorphisms. Eur Respir J. 2001;17(4):728-32.
• Kario K. Obstructive sleep apnea syndrome and hypertension: ambulatory blood pressure. Hypertens Res. 2009;32(6):428-32.
• Bayhan HA, Aslan Bayhan S, İntepe YS, Muhafiz E, Gürdal C. Evaluation of the macular choroidal thickness using spectral optical coherence tomography in patients with obstructive sleep apnoea syndrome. Clin Exp Ophthalmol. 2015;43(2):139-44.
• Xin C, Wang J, Zhang W, Wang L, Peng X. Retinal and choroidal thickness evaluation by SD-OCT in adults with obstructive sleep apnea-hypopnea syndrome (OSAS). Eye (London). 2014;28(4):415-21.
• Ozge G, Dogan D, Koylu MT, Ayyildiz O, Akincioglu D, Mumcuoglu T, et al. Retina nerve fiber layer and choroidal thickness changes in obstructive sleep apnea syndrome. Postgrad Med. 2016;128(3):317-22.