Effects of soft palate implants on acoustic characteristics of voice and articulation

The Effects of the Newest Palatopharyngeal Surgery (Barbed Pharyngoplasty) on Voice Quality

OBJECTIVES

This study aimed to examine the effects of barbed pharyngoplasty (BP) on voice quality in patients with Obstructive sleep apnea syndrome (OSAS) and to compare them with the anterior palatoplasty (AP) and expansion sphincter pharyngoplasty (ESP) surgeries.

METHODS

The study included 329 patients who came to the Otorhinolaryngology Clinic of our hospital with symptoms of snoring and sleep apnea between January 2020 and 2022 and were referred to the sleep laboratory for polysomnography (PSG). AP surgery was recommended for those with retropalatal stenosis in the anteroposterior direction, and ESP surgery for those with lateral stenosis. BP was recommended for those with both anteroposterior and lateral retropalatal stenosis. 60 patients who met the study criteria were included in the study. All surgeries were performed under general anesthesia by the same otolaryngologist within 1 month at the latest after sleep endoscopy. Acoustic voice analysis was performed using the Praat voice analysis program preoperatively and postoperatively at 6 months. F0, jitter, shimmer, and NHR (noise-to-harmonic ratio) were compared between groups pre and postoperatively.

RESULTS

F0 %, jitter %, shimmer %, and NHR % changes were highest in BP. Jitter, shimmer, and NHR decreased significantly in the BP group, whereas F0 increased significantly. Although the mean F0 increased in both AP and ESP groups, the greatest change was in the AP group following BP groups. Although the average jitter, shimmer, and NHR decreased in both groups, the greatest change was in the ESP group following BP groups.

CONCLUSION

In patients with OSAS, BP surgery changed F0, jitter, shimmer and NHR more than AP and ESP surgeries, and effected the voice quality more positively.

The Effects of Anterior Palatoplasty and Functional Expansion Sphincter Pharyngoplasty on Voice Quality in Patients with Obstructive Sleep Apnea

OBJECTIVES

We aimed to examine the effects of anterior palatoplasty (AP) and functional expansion sphincter pharyngoplasty (FESP) on voice quality in patients with OSAS and to compare them with each other.

MERHODS

The study included 380 patients who came to the Otorhinolaryngology Clinic of our hospital with symptoms of snoring and sleep apnea between April 2020 and April 2022 and were referred to the sleep laboratory for polysomnography (PSG).Forty patients who met the study criteria and underwent AP and 26 patients who underwent FESP were included in the study. All surgeries were performed under general anesthesia by the same otolaryngologist within 1 month at the latest after sleep endoscopy. Acoustic voice analysis was performed using the Praat voice analysis program preoperatively and postoperatively at 6 months. F0, jitter, shimmer, and NHR (noise-to-harmonic ratio) were compared between the groups pre and postoperatively.

RESULTS

There were 20 females and 20 males in the AP group, 12 females and 14 males in the FESP group, There was no statistically significant difference in sex distribution between the groups (P = 0.952). The difference between the preop and postop F0, jitter, shimmer, and NHR in both the AP and FESP groups was statistically significant (P < 0.01). After AP and FESP surgeries, F0 values ​​increased, jitter, shimmer and NHR values ​​decreased (P < 0.01).F0, jitter, shimmer, and NHR changes were the greatest in the FESP group.(P < 0.01).

CONCLUSION

Positive changes in F0, jitter, shimmer, and NHR were greatest in the FESP group significantly. FESP surgery affects voice quality more than AP surgery in patients with OSAS.

Voice outcomes for patients undergoing surgery for obstructive sleep apnea: a systematic review and meta-analysis

PURPOSE

To evaluate the effect of the different surgical techniques used in the treatment of obstructive sleep apnea (OSA) on the postoperative voice and nasalance, and to conduct a meta-analysis through the assessment of postoperative changes.

METHODS

Systematic literature review and meta-analysis of published data using the data sources, MEDLINE, Google Scholar, Cochrane, and SAGE. All studies published in English specifying any upper airway surgery for treatment of snoring and/or OSA were included, provided they indicated the pre- and postoperative mean ± standard deviation (SD) values for voice parameters and nasality. The primary outcomes were the changes in preoperative-postoperative mean values of fundamental frequency (mF0), jitter, shimmer, and nasalance scores.

RESULTS

After removal of duplications, 214 studies were potentially relevant, and 25 studies ultimately met the criteria for inclusion in the present review. Of the 25 studies evaluated in this review, 12 studies with 379 patients were available for the meta-analysis calculations. In general, a fixed-effects model was used to analyze the data in the subgroups. The meta-analysis results showed no significant differences in either subgroup analysis between the preoperative and postoperative assessments of mF0, jitter, shimmer, oral nasalance, nasal nasalance, and oronasal nasalance (All had values of p > 0.05).

CONCLUSION

The results of this meta-analysis indicated no significant effect of surgical treatments for snoring or OSA on glottic functioning and nasalance parameters, regardless of surgery type. Further prospective studies are needed to assess more parameters for detailed acoustic analyses.

Comparing the effects of Essix and Hawley retainers on the acoustics of speech

Objective

The aim of this study was to compare the effects of two retainer types (Essix and Hawley) on speech performance.

Subjects and methods

The speech articulation of 30 patients was evaluated prospectively. Five patients did not appear during the follow-up periods. The patients were randomly divided into retention groups by treatment allocation cards as Essix and Hawley. The Essix group included 13 participants with a mean age of 15.3±2.4 years; the Hawley group included 12 participants with a mean age of 16.3±2.56 years. Speech sound assessments were performed on the first day and 1 week, 4 weeks, and 3 months later. On the first day, the assessments were conducted prior to inserting the retainers, immediately after maxillary and mandibular retainer application, individually, and with both retainers applied. The acoustic analyses were obtained using spectral and temporal parameters.

Results

Statistical analyses were performed with IBM SPSS for Windows, version 20. A P value less than 0.05 was considered statistically significant. The most apparent changes were found in the [a] vowel in the Hawley group, the [e] vowel in the Essix group, and the [u] vowel in both groups (P < 0.05). While the number of affected consonant-vowel couples in the Essix group was low, alterations were common in the Hawley group. There was a statistically significant difference (P < 0.05) in voice onset time of the [d] sound between the groups.

Limitations

The trial had a small sample size and a short follow-up period.

Conclusions

The Hawley retainer affected articulatory movements in consonant-vowel combinations more prominently than the Essix retainer did. Voice onset time of the consonant [d] in the Hawley group was shorter than normal, indicating rapid articulatory movement in the alveolar region.

The Effect of Anterior Palatoplasty Plus Modified Expansion Sphincter Pharyngoplasty on Voice Performance in Obstructive Sleep Apnea Syndrome

OBJECTIVE

We aimed to investigate the effect of anterior palatoplasty (AP) plus modified expansion sphincter pharyngoplasty (MESP) on voice performance in patients with obstructive sleep apnea syndrome (OSAS).

METHODS

Fourteen OSAS patients who had AP + MESP procedure were included in the study. Voice performances of the patients were analyzed with acoustic voice analysis before surgery, and 6 months after surgery.

RESULTS

Preoperative and postoperative F0, jitter percentage, and shimmer percentage were compared. Mean preoperative F0 was 129.85 Hz, and mean postoperative F0 was 138.07 Hz, with a significant difference in between (P = 0.017). Mean preoperative jitter percentage was 0.65, and mean shimmer percentage was 0.88, while those values were 0.67 and 0.84, respectively, in the postoperative period. The differences were not statistically significant (P = 0.801 and 0.652).

CONCLUSION

The AP + MESP procedure performed for OSAS results in improvement of F0 in the long term; however, there were no differences in jitter percentage and shimmer percentage.

Assessment of Effects of Septoplasty on Acoustic Parameters of Voice: A Prospective Clinical Study

Objective

To investigate the effects of septoplasty on the acoustic parameters of voice.

Methods

In total, 23 patients (seven females and 16 males; average age, 32.13±9.67 years; age range: 19-56 years) with a diagnosis of nasal septal deviation and who underwent septoplasty were included. Preoperative and on postoperative 30th day, acoustic analysis of voice was conducted for all patients. The recordings of /mana/ vowel were used to evaluate average fundamental frequency (F0), jitter, shimmer, and noise-to-harmony ratio (NHR). F0, shimmer percent, jitter percent, and NHR of two terms were compared. A p-value<0.05 was considered to indicate statistical significance.

Results

A statistically significant change was not observed in F0 (p=0.741), jitter (p=0.930), and shimmer (p=0.128) measured preoperatively and on postoperative day 30. However, the increase in NHR measured on postoperative day 30 were statistically significant compared with preoperative NHR (p=0.017).

Conclusion

According to the findings of this study, except NHR value, no statistically significant changes on F0, jitter and shimmer were detected after septoplasty.

O uso da eletroglotografia, eletromiografia, espectografia e ultrassom nos estudos de fala - revisão teórica

O emprego de novas tecnologias na avaliação e terapia de fala a partir de uma revisão de artigos publicados nos últimos 5 anos é o tema deste estudo, que tem por objetivo realizar uma revisão bibliográfica dos estudos nacionais e internacionais que utilizaram os recursos: eletroglotografia, espectrografia, ultrassonografia e eletromiografia na avaliação e terapia das alterações de fala. Existe um crescente interesse da inserção desses recursos nos estudos de fala, contudo, os trabalhos existentes que os correlacionam ainda são escassos.

Measurement of voice onset time in maxillectomy patients

Objective speech evaluation using acoustic measurement is needed for the proper rehabilitation of maxillectomy patients. For digital evaluation of consonants, measurement of voice onset time is one option. However, voice onset time has not been measured in maxillectomy patients as their consonant sound spectra exhibit unique characteristics that make the measurement of voice onset time challenging. In this study, we established criteria for measuring voice onset time in maxillectomy patients for objective speech evaluation. We examined voice onset time for /ka/ and /ta/ in 13 maxillectomy patients by calculating the number of valid measurements of voice onset time out of three trials for each syllable. Wilcoxon's signed rank test showed that voice onset time measurements were more successful for /ka/ and /ta/ when a prosthesis was used (Z = −2.232, P = 0.026 and Z = −2.401, P = 0.016, resp.) than when a prosthesis was not used. These results indicate a prosthesis affected voice onset measurement in these patients. Although more research in this area is needed, measurement of voice onset time has the potential to be used to evaluate consonant production in maxillectomy patients wearing a prosthesis.

The effect of snoring on voice: a controlled study of 30 subjects

We conducted a study to determine the prevalence of vocal symptoms in snorers. A total of 30 patients with a history of snoring were investigated for the presence or absence of three vocal symptoms immediately after they awoke from sleep: hoarseness, voice weakness, and other changes in voice quality. All patients were also asked to complete a voice-related quality-of-life (V-RQOL) questionnaire. Findings were compared with those of an age- and sex-matched control group of 30 nonsnorers. The most common vocal symptom in the snoring group was hoarseness, which occurred in 11 patients (36.7%); voice weakness and other voice quality changes were present in 8 snorers each (26.7%). In the control group, the most common vocal symptom was voice weakness, which was present in 7 subjects (23.3%); 5 controls (16.7%) experienced other changes in voice quality, and 3 controls (10.0%) experienced hoarseness. The difference between the prevalence of hoarseness in the two groups was statistically significant (p = 0.030), and the differences in voice weakness and other voice quality changes were not. The mean V-RQOL score was 87.50 ± 26.89 in the snoring group and 96.00 ± 5.82 in the control group-again, not a statistically significant difference. Finally, we found no association between any of the three vocal symptoms and the prevalence of mouth breathing, the level of snoring loudness, and the mean number of snores per minute. We conclude that snorers are more likely to experience hoarseness than are nonsnorers.