Effects of Adenotonsillectomy on Acoustic, Perceptual, and Aerodynamic Parameters of Voice

Öz

Objective: In this study, we aimed to investigate the acoustic, perceptual and aerodynamic changes of voice after adenotonsillectomy by using objective methods. Methods: Thirty children, who underwent adenotonsil­lectomy surgery were included. Voice samples were re­corded 1 day before and 1 month after the surgery. Ling­WAVES programme was used as voice analysis program. Mean, maximum and minimum fundamental frequency, Jitter, Shimmer, Glottal to Noise Excitation ratio, Irregular­ity, Noise, Overall Severity, S time, Z time, S/Z ratio, and Maximum Phonation Time parameters were recorded and compared. Results: Shimmer, irregularity, Overall Severity, S/Z Time parameters were significantly lower (p=0.001) and Maximum Phonation Time significantly higher (p=0.001) in the postoperative period than preoperative period. In contrast, no significant differences were observed in the mean fundamental frequency, maximum fundamental fre­quency, minimum fundamental frequency, jitter, Glottal to Noise Excitation, S time and Z time (p>0.05). Conclusion: The changes in some acoustic, aerodynam­ic and perceptual parameters were monitored after ad­enotonsillectomy. Therefore, the families of children who underwent adeotonsillectomy should be warned for any possible changes in voice colors after surgery.

Anahtar Kelimeler

• Adenotonsillectomy
• acoustic analysis
• perceptual analysis
• aerodynamic analysis

Adenotonsillektominin Akustik, Algısal ve Aerodinamik Ses Parametrelerine Etkisi

Öz

Amaç: Bu çalışmada, adenotonsillektomi ameliyatının sesin akustik, algısal ve aerodinamik parametreleri üzerine olan etkilerinin objektif yöntemler ile araştırılması amaçlanmıştır. Yöntemler: Çalışmaya adenotonsillektomi ameliyatı yapılan 30 çocuk hasta katılmıştır. Ses analizleri operasyondan 1 gün önce ve 1 ay sonra olmak üzere 2 kez yapılmıştır. Ses analiz programı olarak LingWAVES kullanılmıştır. Ortalama temel frekans, Maksimum temel frekans, Minimum temel frekans, Jitter, Shimmer, Glottal to Noise Excitation, S time, Z time, S/Z ratio ve Maximum Phonation Time parametreleri karşılaştırılmıştır. Bulgular: Shimmer, irregularity, Overall Severity, S/Z Time parametrelerinin postoperatif değerleri preoperatif döneme göre anlamlı olarak daha düşük (p=0,001), Maximum Phonation Time parametresi ise anlamlı olarak daha yüksek (p=0,001) izlenmiştir. Buna karşılık Ortalama temel frekans, Maksimum temel frekans, Minimum temel frekans, Jitter, Glottal to Noise Excitation, S time, ve Z time parametrelerinde anlamlı farklılık izlenmemiştir (p>0,05). Sonuç: Adenotonsillektomi sonrası bazı akustik, aerodinamik ve algısal ses parametrelerinde değişiklikler izlenmiştir. Bu nedenle adenotonsillektomi yapılacak çocukların aileleri cerrahi sonrası gelişebilecek muhtemel ses rengi değişikliklerine karşın bilgilendirilmelidirler

Anahtar Kelimeler

• Adenotonsillektomi
• akustik analiz
• algısal analiz
• aerodinamik analiz

Kaynakça

1. 1. Chuma AV, Cacace AT, Rosen R, et al. Effects of tonsillectomy and/or adenoidectomy on vocal function: laryngeal, supralaryngeal and perceptual characteristics. Int J Pediatric Otolaryngol 1999;47:1-9.
2. 2. Sarıca S. Ses Analizinde Kullanılan Akustik Parametreler. Tıpta Uzmanlık Tezi 2012;37-45.
3. 3. Oğuz H, Kılıç MA, Şafak MA. Comparison of results in two acoustic analysis programs: Praat and MDVP. Turk J Med Sci 2011;41:835-841.
4. 4. Amir O, Ashkenazi O, Leibovitzh T. Applying the Voice Handicap Index (VHI) to Dysphonic and Non dysphonic Hebre 3w Speakers. J Voice 2006;18:71-82.
5. 5. Samian RA. Ses analizi. Ed: Cummings CW, Flint PW, Harker LA, ve ark. Cummings Otolaringoloji Baş ve Boyun Cerrahisi. (Çev: Koç C.) s. 2008-25, Cilt 3, 4. Basım, Güneş Tıp Kitabevi, Ankara, 2007.
6. 6. Kılıç MA, Okur E, Yıldırım İ. Ses handikap endeksi Türkçe versiyonun güvenilirliği ve geçerliliği. KBB İhtisas Dergisi 2008;18:139-147.
7. 7. Kılıç MA. Evaluation of the patient with voice problem by objective and subjective methods. Curr Prac J Voice. 2007;21:576-590.
8. 8. Karnell MP, Melton SD, Childes JM, et al. Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders. J Voice. 2007;21:576-590.

9. 9. Nemr K, Simões-Zenari M, Cordeiro GF, et al. GRBAS and Cape-V scales: high reliability and consensus when applied at different times. J Voice 2012;26:17-22.
10. 10. Henry LR, Helou LB, Solomon NP, et al. Functional voice outcomes after thyroidectomy: An assessment of the Dsyphonia Severity Index (DSI) after thyroidectomy. Surgery 2010;147:861-870.
11. 11. Michaelis D, Fröhlich M, Strube HW. Selection and combination of acoustic features for the description of pathologic voices. J Acoust Soc Am 1998;103:1628-1639.
12. 12. Fröhlich M, Michaelis D, Strube HW, Kruse E. Acoustic voice analysis by means of the hoarseness diagram. J Speech Lang Hear Res 2000;43:706-720.
13. 13. Lundeborg I, Hultcrantz E, Ericsson E, McAllister A. Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy--effects of surgery. J Voice 2012;26:480-487.
14. 14. Mora R, Crippa B, Dellepiane M, Jankowska B. Effects of adenotonsillectomy on speech spectrum in children. Int J Pediatr Otorhinolaryngol 2007;71:1299-1304.
15. 15. Kandoğan T, Özüer MZ. Effects Of Tonsıllectomy On Acoustıc Parameters. Kbb-Forum 2006;5.
16. 16. Subramaniam V, Kumar P. Impact of tonsillectomy with or without adenoidectomy on the acoustic parameters of the voice: a comparative study. Arch Otolaryngol Head Neck Surg 2009;135:966-969.
17. 17. Dimatos SC, Neves LR, Beltrame JM, et al. Impact of adenotonsillectomy on vocal emission in children. Braz J Otorhinolaryngol. 2016;82:151-158.