The Effect of Nasal Septal Surgeries on Blood Homocysteine Levels

Background: Nasal septum deviation (NSD) is a common anatomic condition that may cause chronic upper airway obstruction, leading to hypoxia and hypercapnia with potential systemic consequences. Chronic hypoxia has been suggested to contribute to endothelial dysfunction through increased oxidative stress and elevated serum homocysteine levels. Homocysteine is a sulfur-containing amino acid with well-established atherogenic properties and is recognized as an independent cardiovascular risk factor. The aim of this study was to investigate the effect of septoplasty on serum homocysteine levels in patients with NSD and to evaluate changes in subjective nasal obstruction symptoms. Methods: This prospective, controlled, and comparative study included 67 patients aged 18 to 50 years with NSD and at least 1 year of nasal obstruction symptoms who underwent septoplasty, along with 67 age- and sex-matched healthy controls. Individuals with systemic diseases, smoking history, or vitamin B12 or folate deficiency were excluded. In the patient group, visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) scores, as well as serum homocysteine levels, were measured preoperatively and at postoperative month 1. Blood samples were obtained under fasting conditions before 10:00 am and analyzed using a validated immunoassay method. In the control group, all measurements were performed once. Statistical analyses were conducted using the Wilcoxon signed-rank test and the Mann-Whitney U test. Results: Postoperatively, VAS and NOSE scores showed a significant decrease in the patient group ( P <0.001). Serum homocysteine levels were also significantly reduced after surgery ( P =0.001). No statistically significant difference was observed between postoperative homocysteine levels in the patient group and those of the control group ( P =0.377). Conclusion: Septoplasty not only effectively alleviates nasal obstruction symptoms related to NSD but may also reduce serum homocysteine levels, potentially modulating cardiovascular risk. These findings suggest that septoplasty may provide systemic benefits beyond local symptomatic improvement.