Effects of septoplasty on speech and voice.

OBJECTIVES: The aim of this study was subjective and objective evaluation of changes in acoustic features of voice before and after septoplasty surgery. STUDY DESIGN: Prospective. METHODS: Twenty patients scheduled for septoplasty procedure were included in the study. Before and 1 and 3 months after septoplasty surgery, acoustic analysis were performed. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), Jitter percent, and Shimmer percent. In spectrographic analyses, F3-F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mana/, and four formant frequencies (F1, F2, F3, and F4) for nasalized /a/ vowel following a nasal consonant /n/ in the word /mana/ were compared. For the perceptual evaluation, the patients were asked to read the Turkish "Dere" passage. The differences in nasal resonance and subjective evaluations were rated. RESULTS: A statistically significant change was not observed in F0 (P=0.307), Jitter (P=0.919), and Shimmer (P=0.024) values measured before and after the operation for vowel /a/. Nasal formants measured before and after the operation for nasal formant /m/ and nasal formant /n/ in the word /mana/, which contains nasal consonants, and nasalized vowel /a/, which comes after a nasal consonant, did not differ statistically significant (P=0.096 and P=0.034, respectively). Comparisons among F1, F2, F3, and F4 values did not reveal a statistically significant change for nasalized vowel /a/, which comes after a nasal consonant in the word /mana/. CONCLUSIONS: Our study shows that a complete therapeutic approach to patients affected by nasal septum deviation do not reveal significant voice abnormalities.

Window anterior commissure relaxation laryngoplasty in the management of high-pitched voice disorders.

OBJECTIVE: To present the success rate of a less invasive modification of Isshiki type III anterior commissure relaxation laryngoplasty technique in patients with high-pitched voice disorders. DESIGN: Prospective case series. SETTING: KBB Major Private Clinic of Istanbul Surgery Hospital and the University of Yeditepe Hospital. PATIENTS: Twenty-one adult patients who believed that their high-pitched voices conflicted with their body image and/or gender identity. INTERVENTION: Type III thyroplasty for pitch alteration. MAIN OUTCOME MEASURES: Comparison of preoperative and postoperative (>6 months) fundamental frequency levels, diplophonia, perception of body image and pitch, and subjective ratings of comfort during vocalization. RESULTS: The patients were mostly male (mean age, 30.5 years). The most frequent cause of high-pitched voice was sulcus vocalis (n = 14), followed by constitutional causes (n = 5), mutational falsetto (n = 1), and severe glottic scarring secondary to childhood diphtheria (n = 1). After surgery, the fundamental frequency dropped significantly from a mean of 213.81 Hz to 149.86 Hz (P < .001), equaling a mean postoperative semitone drop of 6.23. Misperception leading to an abnormal body image was reduced by 86%. Fourteen patients who originally had feelings of tension and fatigue during phonation and vocalization gained comfort postoperatively. Diplophonia with subharmonic signals observed in 11 cases preoperatively was reduced or disappeared in 6 cases. No complications or failures were observed during the follow-up period. CONCLUSION: Window anterior commissure relaxation laryngoplasty is an efficient, easy, less invasive, and safe procedure in the surgical management of organic and functional high-pitched voice disorders.