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The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps

Year 2017, Volume: 27 Issue: 1, 10 - 14, 05.03.2017

Abstract

Objectives: This study aims to evaluate the right ventricular functions before and after functional endoscopic sinus surgery FESS in patients with nasal polyps NPs . Patients and Methods: A total of 56 patients 36 males, 20 females; mean age 30±10 years; range 19 to 40 years with grade II and III NP were included in the study between March 2015 and January 2016. The conventional echocardiographic parameters, pulmonary artery systolic pressure PASP , tricuspid annular plane systolic excursion TAPSE , right ventricular fractional change area RVFAC , and peripheral oxygen saturation with a pulse oximeter were measured in all patients before and one month after surgery. Results: The PASP statistically significantly decreased during the postoperative period p=0.003 . Right ventricular fractional change area and TAPSE, which are right ventricular systolic parameters, improved significantly after FESS p=0.005 and p=0.009, respectively . Peripheral oxygen saturation increased from 94.0±0.9 to 94.7±0.8 during the postoperative period p=0.005 . Conclusion: Our study results indicate that treatment of upper airway obstruction in adult patients with NP may result in improved right ventricular systolic functions and provide a substantial decrease in PASP values.

References

  • Bachert C, Gevaert P, Holtappels G, Cuvelier C, van Cauwenberge P. Nasal polyposis: from cytokines to growth. Am J Rhinol 2000;14:279-90.
  • Blum RH, McGowan FX Jr. Chronic upper airway obstruction and cardiac dysfunction: anatomy, pathophysiology and anesthetic implications. Paediatr Anaesth 2004;14:75-83.
  • Sofer S, Weinhouse E, Tal A, Wanderman KL, Margulis G, Leiberman A, et al. Cor pulmonale due to adenoidal or tonsillar hypertrophy or both in children. Noninvasive diagnosis and follow-up. Chest 1988;93:119-22.
  • Kukulski T, Hübbert L, Arnold M, Wranne B, Hatle L, Sutherland GR. Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study. J Am Soc Echocardiogr 2000;13:194-204.
  • Vendelo Johansen L, Illum P, Kristensen S, Winther L, Vang Petersen S, Synnerstad B. The effect of budesonide (Rhinocort) in the treatment of small and medium-sized nasal polyps. Clin Otolaryngol Allied Sci 1993;18:524-7.
  • Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology 1993;31:183-4.
  • Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-63.
  • Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
  • Yilmaz MD, Onrat E, Altuntaş A, Kaya D, Kahveci OK, Ozel O, et al. The effects of tonsillectomy and adenoidectomy on pulmonary arterial pressure in children. Am J Otolaryngol 2005;26:18-21.
  • Potsic WP, Pasquariello PS, Baranak CC, Marsh RR, Miller LM. Relief of upper airway obstruction by adenotonsillectomy. Otolaryngol Head Neck Surg 1986;94:476-80.
  • Fidan V, Aksakal E. Impact of septoplasty on pulmonary artery pressure in patients with markedly deviated septum. J Craniofac Surg 2011;22:1591-3.
  • Ozkececi G, Akci O, Bucak A, Ulu S, Yalım Z, Aycicek A, et al. The effect of septoplasty on pulmonary artery pressure and right ventricular function in nasal septum deviation. Eur Arch Otorhinolaryngol 2016;273:3747-52.
  • McGowan FX Jr. Cardiovascular and airway interactions. Int Anesthesiol Clin 1992;30:21-44.
  • Şimşek E, Şimşek Z, Taş MH, Kucur C, Günay E, Üçüncü H. Evaluation of right ventricular functions in patients with nasal polyposis: an observational study. Anadolu Kardiyol Derg 2013;13:251-6.
  • Fuster V, Steele PM, Edwards WD, Gersh BJ, McGoon MD, Frye RL. Primary pulmonary hypertension: natural history and the importance of thrombosis. Circulation 1984;70:580-7.
  • Elguindy Wm, Sobhy Ts. Adenoid hypertrophy and its relation with right ventricular function. Life Sci J 2013;10:545-50.
  • Tezer MS, Karanfil A, Aktaş D. Association between adenoidal-nasopharyngeal ratio and right ventricular diastolic functions in children with adenoid hypertrophy causing upper airway obstruction. Int J Pediatr Otorhinolaryngol 2005;69:1169-73.
  • Zakaria D, Sachdeva R, Gossett JM, Tang X, O’Connor MJ. Tricuspid annular plane systolic excursion is reduced in infants with pulmonary hypertension. Echocardiography 2015;32:834-8.

Nazal polipli hastalarda fonksiyonel endoskopik sinüs cerrahisinin sağ ventrikül fonksiyonu üzerine etkisi

Year 2017, Volume: 27 Issue: 1, 10 - 14, 05.03.2017

Abstract

Amaç: Bu çalışmada nazal polipli NP hastalarda fonksiyonel endoskopik sinüs cerrahisi FESS öncesi ve sonrası sağ ventrikül fonksiyonları değerlendirildi.Hastalar ve Yöntemler: Mart 2015 - Ocak 2016 tarihleri arasında grad II ve III NP’li toplam 56 hasta 36 erkek, 20 kadın; ort yaş 30±10 yıl; dağılım 19-40 yıl çalışmaya dahil edildi. Tüm hastalarda cerrahiden önce ve bir ay sonra konvansiyonel ekokardiyografik parametreler, pulmoner arter sistolik basıncı PASP , triküspit anüler plan sistolik hareketi TAPSE , sağ ventrikül fraksiyonel alan değişimi RVFAC ve pulse oksimetre ile periferik oksijen satürasyonları ölçüldü.Bulgular: Ameliyat sonrası dönemde PASP istatistiksel olarak anlamlı düzeyde azaldı p=0.003 . Sağ ventrikül sistolik parametrelerinden RVFAC ve TAPSE değerleri, FESS sonrası anlamlı düzeyde iyileşme gösterdi sırasıyla p=0.005 ve p=0.009 . Periferik oksijen satürasyonu, ameliyat sonrası dönemde 94.0±0.9’ten, 94.7±0.8’e yükseldi p=0.005 .Sonuç: Çalışma sonuçlarımız NP’li erişkin hastalarda üst solunum yolu tıkanıklığının tedavisinin sağ ventrikül sistolik fonksiyonları iyileştirebileceğini ve PASP değerinde önemli bir azalma sağlayabileceğini göstermektedir

References

  • Bachert C, Gevaert P, Holtappels G, Cuvelier C, van Cauwenberge P. Nasal polyposis: from cytokines to growth. Am J Rhinol 2000;14:279-90.
  • Blum RH, McGowan FX Jr. Chronic upper airway obstruction and cardiac dysfunction: anatomy, pathophysiology and anesthetic implications. Paediatr Anaesth 2004;14:75-83.
  • Sofer S, Weinhouse E, Tal A, Wanderman KL, Margulis G, Leiberman A, et al. Cor pulmonale due to adenoidal or tonsillar hypertrophy or both in children. Noninvasive diagnosis and follow-up. Chest 1988;93:119-22.
  • Kukulski T, Hübbert L, Arnold M, Wranne B, Hatle L, Sutherland GR. Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study. J Am Soc Echocardiogr 2000;13:194-204.
  • Vendelo Johansen L, Illum P, Kristensen S, Winther L, Vang Petersen S, Synnerstad B. The effect of budesonide (Rhinocort) in the treatment of small and medium-sized nasal polyps. Clin Otolaryngol Allied Sci 1993;18:524-7.
  • Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology 1993;31:183-4.
  • Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005;18:1440-63.
  • Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
  • Yilmaz MD, Onrat E, Altuntaş A, Kaya D, Kahveci OK, Ozel O, et al. The effects of tonsillectomy and adenoidectomy on pulmonary arterial pressure in children. Am J Otolaryngol 2005;26:18-21.
  • Potsic WP, Pasquariello PS, Baranak CC, Marsh RR, Miller LM. Relief of upper airway obstruction by adenotonsillectomy. Otolaryngol Head Neck Surg 1986;94:476-80.
  • Fidan V, Aksakal E. Impact of septoplasty on pulmonary artery pressure in patients with markedly deviated septum. J Craniofac Surg 2011;22:1591-3.
  • Ozkececi G, Akci O, Bucak A, Ulu S, Yalım Z, Aycicek A, et al. The effect of septoplasty on pulmonary artery pressure and right ventricular function in nasal septum deviation. Eur Arch Otorhinolaryngol 2016;273:3747-52.
  • McGowan FX Jr. Cardiovascular and airway interactions. Int Anesthesiol Clin 1992;30:21-44.
  • Şimşek E, Şimşek Z, Taş MH, Kucur C, Günay E, Üçüncü H. Evaluation of right ventricular functions in patients with nasal polyposis: an observational study. Anadolu Kardiyol Derg 2013;13:251-6.
  • Fuster V, Steele PM, Edwards WD, Gersh BJ, McGoon MD, Frye RL. Primary pulmonary hypertension: natural history and the importance of thrombosis. Circulation 1984;70:580-7.
  • Elguindy Wm, Sobhy Ts. Adenoid hypertrophy and its relation with right ventricular function. Life Sci J 2013;10:545-50.
  • Tezer MS, Karanfil A, Aktaş D. Association between adenoidal-nasopharyngeal ratio and right ventricular diastolic functions in children with adenoid hypertrophy causing upper airway obstruction. Int J Pediatr Otorhinolaryngol 2005;69:1169-73.
  • Zakaria D, Sachdeva R, Gossett JM, Tang X, O’Connor MJ. Tricuspid annular plane systolic excursion is reduced in infants with pulmonary hypertension. Echocardiography 2015;32:834-8.
There are 18 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Eda Şimşek This is me

Selami Demirelli This is me

Ziya Şimşek This is me

Emrah İpek This is me

Fatih Bingöl This is me

Yavuzer Koza This is me

Emrah Ermiş This is me

Publication Date March 5, 2017
Published in Issue Year 2017 Volume: 27 Issue: 1

Cite

APA Şimşek, E., Demirelli, S., Şimşek, Z., İpek, E., et al. (2017). The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps. The Turkish Journal of Ear Nose and Throat, 27(1), 10-14.
AMA Şimşek E, Demirelli S, Şimşek Z, İpek E, Bingöl F, Koza Y, Ermiş E. The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps. Tr-ENT. March 2017;27(1):10-14.
Chicago Şimşek, Eda, Selami Demirelli, Ziya Şimşek, Emrah İpek, Fatih Bingöl, Yavuzer Koza, and Emrah Ermiş. “The Effect of Functional Endoscopic Sinus Surgery on Right Ventricular Function in Patients With Nasal Polyps”. The Turkish Journal of Ear Nose and Throat 27, no. 1 (March 2017): 10-14.
EndNote Şimşek E, Demirelli S, Şimşek Z, İpek E, Bingöl F, Koza Y, Ermiş E (March 1, 2017) The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps. The Turkish Journal of Ear Nose and Throat 27 1 10–14.
IEEE E. Şimşek, S. Demirelli, Z. Şimşek, E. İpek, F. Bingöl, Y. Koza, and E. Ermiş, “The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps”, Tr-ENT, vol. 27, no. 1, pp. 10–14, 2017.
ISNAD Şimşek, Eda et al. “The Effect of Functional Endoscopic Sinus Surgery on Right Ventricular Function in Patients With Nasal Polyps”. The Turkish Journal of Ear Nose and Throat 27/1 (March 2017), 10-14.
JAMA Şimşek E, Demirelli S, Şimşek Z, İpek E, Bingöl F, Koza Y, Ermiş E. The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps. Tr-ENT. 2017;27:10–14.
MLA Şimşek, Eda et al. “The Effect of Functional Endoscopic Sinus Surgery on Right Ventricular Function in Patients With Nasal Polyps”. The Turkish Journal of Ear Nose and Throat, vol. 27, no. 1, 2017, pp. 10-14.
Vancouver Şimşek E, Demirelli S, Şimşek Z, İpek E, Bingöl F, Koza Y, Ermiş E. The effect of functional endoscopic sinus surgery on right ventricular function in patients with nasal polyps. Tr-ENT. 2017;27(1):10-4.