Resonance change is a common clinical symptom in individuals with deviated nasal septum. Often this anatomical deficit is surgically treated by septoplasty. Therefore monitoring resonance changes using acoustical tools is vital. Hence, the study investigated cepstral measure differences in subjects with deviated nasal septum compared to normals. A case-control study design involving 20 subjects within 18-40 years divided into Group I of 10 subjects with deviated nasal septum (DNS) and Group II of 10 normal subjects participated. All the subjects sustained nasalized vowel /ã/ at 10 cm mouth-microphone distance for minimum of 5 seconds. For Group I, voice sample was recorded in 2 conditions, 2 days pre-septoplasty and 1 month post-septoplasty. Cepstral peak prominence (CPP) and smooth cepstral peak prominence (CPPS) values was extracted using the Hillenbrand algorithm. Mean values revealed increased CPP and CPPS measure post-septoplasty when compared to pre-septoplasty. ANOVA showed statistically significant difference only for CPPS at p = 0.00. The higher cepstral values of post-septoplasty is due to widened nasal passage that leads to increased nasal volume, decreased acoustic damping and increased nasal patency. These changes in supraglottic chambers will result in a better acoustic space for good resonance. However, the CPPS values were not similar to normal subjects because of scarring or incomplete recovery of the outer mucosal layer of the nasal tract. Thus, we can conclude that cepstral analysis is a sensitive tool to detect resonance changes in the nasal patency.
Background and objective: Functional endoscopic sinus surgery (FESS) increases the nasal volume, and thereby it can alter the nasal resonance. The objectives were to measure the percentage of nasal resonance following FESS and compare it with healthy individuals with normal nasal findings. Methods:The nasometric analysis of voice was done using n/p/m consonant sounds in 72 individuals with healthy post FESS cavities (group 1) and 72 healthy individuals with normal nasal findings without any nasal pathology (group 2). The scores of nasal resonances were expressed in percentages and were compared between the two groups. Both in group 1 and group 2, 32 (44.4%) were females, and 40(55.6%) were males. In group 1, 51 participants had bilateral FESS cavities, and 21 had unilateral FESS cavities. Kannada was the mother tongue in 30 (41.7%) participants in group 1 and 36 (50.0%) in group 2. Malayalam was the mother tongue in 42(58.3%) participants in group 1 and 36 (50.0%) in group 2.Results: In both cases and control groups, more than 80% of the participants were showing less than 20% of nasal resonance. In group 1, the mean values of/n/p/m sounds were 11.23%, 10.23% and 11.42% respectively, and in group 2 the mean values were 8.27%, 8.58% and 8.58% respectively. But the P value was not statistically significant. Individuals with unilateral FESS cavities had more nasal resonance values compared to bilateral FESS cavities. Similarly, Kannada speaking people had more values compared to Malayam speaking individua. Conclusion:Changes in nasal resonance after FESS is minimal, and it is unnoticed.But it may affect the speech quality in professional voice users, depending on their language. Though the nasometer is considered as the most validated instrument to record nasal resonance, we feel that further standardization is needed to evaluate the nasalance.
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