Changes in nasal resonance after functional endoscopic sinus surgery
ABSTRACT Hyponasality may be present in patients with chronic rhinosinusitis because of decreased resonance of nasal cavities. Nasalance is a parameter of nasality measured by a nasometer. This study investigated the influence of functional endoscopic sinus surgery (FESS) on nasalance and determined the correlation of the nasalance change with nasal volume change.
When patients with chronic rhinosinusitis underwent FESS, nasalance was measured by nasometry and nasal volume was measured by acoustic rhinometry before and at least 6 months after surgery.
There were 81 eligible patients enrolled in the study. Nasalance scores and nasal volumes were significantly increased after FESS. The increased nasalance value was moderately correlated with the increased midnasal and postnasal volumes. The correlation between postoperative changes in nasalance scores and nasal volumes was more remarkable in patients without nasal polyps than in those with nasal polyps and it was also higher in patients with allergic rhinitis than in those without allergic rhinitis.
This study showed that the FESS effectively increased nasalance scores and nasal volumes in patients with chronic rhinosinusitis, but the increase in nasalance scores did not appear to be achieved largely through the increased nasal volumes.
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ABSTRACT: Patients undergoing surgery for a deviated nasal septum (septoplasty) often report that their voice sounds different or less hyponasal. However, such a relationship between septoplasty and vocal resonance remains without scientific evidence. The purpose of this work is to investigate whether nasal septal surgery has any effect on nasal resonance, both in terms of objective measurements and patient perception. The research carried out was a prospective case-control study. We recruited patients who underwent septoplasty (study group) and healthy volunteers (control group). We obtained voice recordings of the nasal consonant /m/ pre- and four weeks postoperatively and twice at similar time intervals in the control group. We investigated objective changes by means of acoustic analysis of the voice recordings and calculated the total amount of acoustic energy in different bandwidths on a wide-band spectrogram. We also utilized a questionnaire to explore patient perception. A total of 34 participants entered the study. ANOVA testing revealed significant changes in average total acoustic energy, phlegm, and throat dryness postoperatively. Regarding patient perception, a considerable number of our patients felt that their voice had changed for the better upon direct questioning. However, statistical analysis of the questionnaire items related to nasality of voice did not show a significant change. In this study it has been demonstrated that surgical correction of septal deviation causes significant spectrographic changes. In particular it causes changes in the average total acoustic energy during the production of a nasal consonant. A considerable number of our patients reported change in their vocal resonance for the better. We recommend that patients be advised that their voice may sound different after surgery, or less hyponasal.Logopedics, phoniatrics, vocology 04/2015; DOI:10.3109/14015439.2015.1007160 · 0.82 Impact Factor
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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.Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 11/2014; DOI:10.1007/s00405-014-3386-7 · 1.61 Impact Factor
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ABSTRACT: Changes in nasalance caused by resonance change after endonasal surgeries have been reported in prior studies. In clinical practice, although patients often complain of a nasal voice just after surgery, their voices recover over time. The objective of this study was to evaluate the long-term nasalance changes before and after endonasal surgery. Patients who underwent sinonasal surgery at Yeouido St. Mary's Hospital between March 2009 and July 2011 were included in this study. We classified the subjects into three groups according to the surgeries they underwent: group 1, the septoturbinoplasty group; group 2, the endoscopic sinus surgery group; and group 3, the septoturbinoplasty and endoscopic sinus surgery group. We checked acoustic profiles, Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scores, and nasalance using a nasometer before and after the sinonasal surgery. When considering multidimensional voice program results, no observed parameters showed statistically meaningful changes before or after the operation in all three groups. GRBAS scales in all patients changed less than two scales postoperatively. Nasalance increased at 1 month after the operation in all groups. However, it returned to original levels with time: 3 months in group 2 and 6 months in groups 1 and 3. Sinonasal surgery can change the acoustic characteristics of the vocal tract and produce a significant increase in nasality in the early phase. However, after proper healing of the nasal cavity, nasality was observed to become similar to the preoperative level. Therefore, patients, especially voice professionals, do not need to be wary of voice changes after sinonasal surgery.American Journal of Rhinology and Allergy 01/2013; 27(1):67-70. DOI:10.2500/ajra.2013.27.3832 · 2.18 Impact Factor