Effects of Changes in Nasal Volume on Voice in Patients after Endoscopic Endonasal Transsphenoidal Surgery

• Published in: American journal of rhinology & allergy 2017-05, Vol.31 (3), p.177-180
• Main Authors: Kim, Do Hyun, Hong, Yong-Kil, Jeun, Sin-Soo, Park, Jae-Sung, Kim, Soo Whan, Cho, Jin Hee, Park, Yong Jin, Lee, Hyuck Jae, Hwang, Yeon-Shin, Kim, Sung Won
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Endoscopy; Female; Humans; Male; Middle Aged; Nasal Cavity - anatomy & histology; Nasal Cavity - metabolism; Nasal Cavity - surgery; Paranasal Sinuses - diagnostic imaging; Paranasal Sinuses - surgery; Postoperative Period; Rhinometry, Acoustic; Sphenoid Bone - surgery; Surgical Flaps - utilization; Tomography, X-Ray Computed; Voice - physiology; Young Adult
• ISSN: 1945-8924; 1945-8932
• DOI: 10.2500/ajra.2017.31.4432

Objective To investigate a potential correlation between changes in voice and changes in nasal volume. Methods The endoscopic endonasal transsphenoidal approach (EETSA) was performed on 120 patients between February 2009 and August 2016 by using the bilateral modified nasoseptal rescue flaps method. All the patients were subjected to pre- and postoperative paranasal computed tomography (CT) and voice evaluations by using acoustic analyses, a nasometer to measure the nasalance, and determination of the voice handicap index (VHI). Paranasal CT and the medical image processing software were used to calculate changes in nasal cavity volume in three nasal sections. Results Enlargement of the nasal cavity after surgery was evident in all three areas (anteronasal, p < 0.001; midnasal, p = 0.005; postnasal, p = 0.025). In addition, EETSA resulted in significantly higher mean nasalance scores for the oronasal passage (p < 0.001) and nasal passage (p < 0.001); more frequency perturbation (jitter) (p < 0.001) and amplitude perturbation (shimmer) (p < 0.001); and higher grade, roughness, breathiness, asthenia, and strain scores (p < 0.001), and VHI (p = 0.01). However, only changes in the nasal volume after EETSA correlated with postnasal hypernasality (r = 0.2; p = 0.029). Conclusion Although changes in nasal volume, voice, and speech may develop after EETSA, we found that changes in nasal volume were not correlated with changes in any voice-quality measure. However, the postnasal cavity was the region most dramatically affected by EETSA, and postnasal volume changes after surgery may be associated with hypernasal speech.