Changes and recovery of voice quality after sinonasal surgery

Abstract

Changes in the configuration of sinonasal cavity after surgery have been assumed to cause changes in the voice quality. The purpose of this study was to know when the hypernasality will be recovered after sinonsal surgery in patients with nasal septal deviation or chronic rhinosinusitis by checking long-term and serially obtained nasalance scores using nasometer. Sixty-five patients underwent sinonasal surgery were included. We classified the subjects into three groups according to the different surgical interventions employed: septoplasty group, endoscopic sinus surgery (ESS) group, and ESS with septoplasty group. The nasalance scores were obtained using a nasometer preoperatively, 1, 2, 3, 4, 5, and 6 months after surgery. The mean nasalance scores for vowels, nasal consonant, plosive consonant-vowel combinations, nasal consonant-vowel combinations, a hypernasality sentence, and hyponasality sentence increased significantly after sinonasal surgery. Hypernasality was most prominent in all groups for all acoustic parameters 1 month after surgery. Thereafter nasality decreased and returned to its preoperative level in all groups at 5 months in the [m], [ma], [mi], and hypernasality sentence, but at 6 months in the [a], [i], [u], [p(h)a], [p(h)i], and hyponasality sentence. Sinonasal surgery can change the acoustic characteristics of the vocal tract and produce a significant increase in nasality. After nasality showed the highest scores at 1-month post-surgery, it returned to its preoperative level at 5 or 6 months after surgery depending on the subtype of speech stimuli.

Does Nasal Surgery Affect Voice Outcomes? A Systematic Review with Meta-Analyses

“…A total of 483 unique articles resulted from the initial query and bibliography selection. Upon review, 19 studies with 697 patients were eligible to be included in qualitative assessment (Figure 1); these included six case-control studies 3,12-16 with a total of 169 patients and 13 case series studies 2,5-9,17-23 with a total of 523 patients. Eight studies qualified for quantitative review.…”

“…Eight studies qualified for quantitative review. 2,3,5,6,8,16,19,20 Outcome measures included nasalance scores, formant scores, scores of F0, jitter, shimmer, and HNR, and patient voice perception scores. Based on initial diagnosis, seven studies investigated patients with chronic rhinosinusitis (CRS), 5-9,17,21 nine studies included patients with a deviated nasal septum (DNS), 2,6,8,12,14-16,19,20 three studies included nasal polyposis, 13,18,23 one study examined inferior concha hypertrophy, 3 and one study selected patients with internal nasal valve collapse.…”

Voice outcomes after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis

“…Our data show an improvement in both QoL as well as subjective voice outcome measures following ESS. Sinonasal surgery can change the acoustic characteristics of the vocal tract and produce a significant increase in nasalance, objectively measured with nasometry . The nasometer is an instrument that computes an acoustic measurement based on the ratio of sound intensities arising from the nasal and oral cavities during phonation .…”

“…Sinonasal surgery can change the acoustic characteristics of the vocal tract and produce a significant increase in nasalance, objectively measured with nasometry. 10 The nasometer is an instrument that computes an acoustic measurement based on the ratio of sound intensities arising from the nasal and oral cavities during phonation. 5 Nasalance is obviously influenced by nasal airway obstruction, because with complete airway obstruction, the nasalance score is 0.…”

Changes in Voice and Nasal Resonance After Septoplasty

“…Çalışmamızdaki önermemiz ile benzer şekilde Kim ve ark., septoplasti ve endoskopik sinüs cerrahisi uygulanan hastalarda, septum deviasyonunun düzeltilmesi ve sinüs ostiyumlarının genişlemesi ile oluşan nazal kavite hacmindeki ve direncindeki değişikliklerin nazalans skorunu etkileyebileceğini söylemişlerdir. 15 Nazalans skorunda cerrahinin 1. ayında en yüksek artışın olduğu ve takiplerde kademeli olarak azalmanın olduğunu bildirmişlerdir. Kontrolün 4. ayında nazalans skorları, preoperatif dönemdeki değerlerden anlamlı derecede yüksek olmasına rağmen kontrolün 6. ayında preoperatif değerlere gerilemiştir.…”