Parasympathetic overactivity in patients with nasal septum deformities

Nasal septum deformities (NSD) are one of the most frequent reasons for nasal obstruction presented with a reduction in nasal airflow and chronic mucosal irritation. Nasocardiac reflex which includes afferent stimulus with maxillary division of the trigeminal nerve and the efferent pathway of the heart via the vagus nerve is not a well-known part of autonomic nervous system (ANS). Heart rate variability (HRV) is a parameter reflecting the ANS activity on heart. The purpose of this study is to evaluate ANS functions in patients with NSD by HRV analysis. Twenty-nine patients with NSD and 26 control subjects were included in the study. The diagnosis of NSD was made with history, symptoms, anterior rhinoscopy, and nasal endoscopic examination. 24-h ambulatory electrocardiographic recording was performed by a 3-channel recorder. HRV parameters were obtained by analyzing these parameters. Baseline features were similar in patients and controls (mean age: 31 ± 8 in the patients, 32 ± 9 in control subjects; P = NS). Night-RMSSD (the square root of square of mean square differences of successive NN intervals) (47 ± 21, 34 ± 13; P = 0.008), night-PNN50 (the number of interval differences of successive NN intervals greater than 50 ms) (24 ± 16, 14 ± 10; P = 0.007), 24-h-RMSSD (39 ± 18, 27 ± 12; P = 0.004), and 24-h-PNN50 (16 ± 12, 9 ± 7; P = 0.016) were significantly higher in patients than controls. Other HRV parameters were not significantly different between two groups. Changes in these parameters demonstrated an increased parasympathetic tone and discordance in sympatho-vagal activity in NSD.