Introduction There is change in nasalance post endonasal surgery which is not permanent.
Objectives The objective of this study is to evaluate the long-term nasalance changes following different types of endonasal surgeries.
Methods We included in this study patients who underwent sinonasal surgery at the Otorhinolaryngology Department in Zagazig University Hospitals from February 2015 until March 2016. We divided the patients into two groups according to the surgeries they underwent: Group (A) was the FESS group and group (B), the septoturbinoplasty group. We checked nasalance using a nasometer before and after the sinonasal surgery.
Results Nasalance increased at one month after the operation in both groups. However, it returned to nearly original levels within three months postoperatively.
Conclusion FESS, septoplasty, and turbinate surgery may lead to hypernasal speech. This hypernasal speech can be a result of change in the shape and diameter of the resonating vocal tract. Hypernasal speech in these circumstances may be a temporary finding that can decrease with time. Surgeons should inform their patients about the possibility of hypernasality after such types of surgery, especially if they are professional voice users.
Our study highlights the significant reduction in OB volume in patients with bilateral sinonasal polyposis as compared with its volume in healthy controls. Further studies are required to evaluate the impact of OB volume reduction on olfactory recovery postoperatively.
Introduction Although medialization thyroplasty utilizing Gore-Tex (Gore and Associates, Newark, Delaware, United States) has been discussed in the literature, few reports have assessed voice quality afterward, and they did not use a full assessment protocol.
Objective To assess the improvement in voice quality after medialization thyroplasty utilizing Gore-Tex in patients with glottic insufficiency of variable etiology.
Methods Eleven patients with glottic insufficiency of different etiologies that failed compensation were operated by type 1 thyroplasty utilizing Gore-Tex. Pre- and postoperative (1 week, 3 months, and 6 months) voice assessment was done and statistical analysis was performed on the results.
Results In all postoperative assessments, there was significant improvement in the grade of dysphonia (p < 0.004) and highly significant reduction in the size of glottic gap and prolongation of maximum phonation time (p < 0.0001). The difference in voice parameters in the early (1 week) and the late (3 and 6 months) postoperative period was not significant. None of the patients developed stridor or shortness of breath necessitating tracheotomy, and there was no implant extrusion in any patient during the study period.
Conclusion Gore-Tex medialization provides reliable results for both subjective and objective voice parameters. It leads to a satisfactory restoration of voice whatever the etiology of glottic incompetence is. This technique is relatively easy and does not lead to major complications. Further studies with larger number of patients and more extended periods of follow-up are still required to assess the long-term results of the technique regarding voice quality and implant extrusion.
Introduction
Since oropharyngeal surgery alone is often insufficient to treat obstructive sleep apnea (OSA), advances have been developed in hypopharyngeal surgery.
Objective
To assess hyoid suspension surgery as part of a multilevel OSA surgery, also including palatal surgery.
Methods
The study included patients with OSA symptoms with apnea hypopnea index (AHI) > 15. They were scheduled for hyoid suspension after a nasoendoscopy during Müller maneuver and drug induced sleep endoscopy (DISE). All patients had body mass index (BMI) < 35 kg/m2. Hyoidothyroidopexy combined with tonsillectomy and palatal suspension was performed in all cases.
Results
The mean AHI dropped significantly (
p
< 0.0001) from 68.4 ± 25.3 preoperatively to 25.6 ± 9.52 postoperatively. The mean lowest oxygen (O
2
) saturation level increased significantly from 66.8 ± 11.3 to 83.2 ± 2.86 (
p
< 0.0001). In addition, the snoring score significantly decreased (
p
< 0.0001) from a preoperative mean of 3.4 ± 0.54 to 2 ± 0.7 at 6 months postoperatively. In regard to the Epworth sleepiness scale (ESS), it showed significant improvements (
p
< 0.0001) as its mean diminished from 13.8 ± 5.4 preoperatively to 5.2 ± 1.6 postoperatively.
Conclusion
Hyoidothyroidopexy using absorbable suture seems to produce a good outcome in treating OSA. It could be effectively and safely combined with other palatal procedures in the multilevel surgery for OSA.
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