Relationship between nasal valve changes and nasalance of the voice

Effects of changes in nasal volume on voice in patients after endoscopic endonasal transsphenoidal surgery

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.

Comparison of Acoustic and Stroboscopic Findings and Voice Handicap Index between Allergic Rhinitis Patients and Controls

BACKGROUND

In our experience Allergic Rhinitis (AR) patients suffer from voice problems more than health subjects.

AIMS

To investigate the acoustic analysis of voice, stroscopic findings of larynx and Voice Handicap Index scores in allergic rhinitis patients compared with healthy controls.

STUDY DESIGN

Case-control study.

METHODS

Thirty adult patients diagnosed with perennial allergic rhinitis were compared with 30 age- and sex-matched healthy controls without allergy. All assessments were performed in the speech physiology laboratory and the testing sequence was as follows: 1. Voice Handicap Index (VHI) questionnaire, 2. Laryngovideostroboscopy, 3. Acoustic analyses.

RESULTS

No difference was observed between the allergic rhinitis and control groups regarding mean Maximum Phonation Time (MPT) values, Fo values, and stroboscopic assessment (p>0.05). On the other hand, mean VHI score (p=0.001) and s/z ratio (p=0.011) were significantly higher in the allergic rhinitis group than in controls.

CONCLUSION

Our findings suggest that the presence of allergies could have effects on laryngeal dysfunction and voice-related quality of life.

External nasal dilators: definition, background, and current uses

Our goal was to revise the literature about external nasal dilators (ENDs) as to their definition, history, and current uses. We reviewed journals in the PubMed and MEDLINE databases. The current uses hereby presented and discussed are physical exercise, nasal congestion and sleep, snoring, pregnancy, cancer, and healthy individuals. Numerous studies have shown that ENDs increase the cross-sectional area of the nasal valve, reducing nasal resistance and transnasal inspiratory pressure and stabilizing the lateral nasal vestibule, avoiding its collapse during final inspiration. These effects also facilitate breathing and are beneficial to patients with nasal obstruction. Furthermore, END use is simple, noninvasive, painless, affordable, and bears minimum risk to the user. Most studies have limited sample size and are mainly focused on physical exercise. In conclusion, ENDs seem useful, so further studies involving potential effects on the performance of physical tests and improvements in sleep quality are necessary, especially in children and teenagers.

Evaluation of the effectiveness of the external nasal dilator strip in adolescent athletes: a randomized trial

OBJECTIVES

Evaluate the cardio-respiratory capacity (VO₂max.) and peak nasal inspiratory flow (PNIF) of healthy adolescent athletes with experimental and placebo external nasal dilator strips (ENDS).

METHODS

48 healthy adolescent athletes between the ages of 11 and 15 were evaluated and submitted to a cardio-respiratory 1000 m race in randomized order. The participants had peak nasal inspiratory flow (PNIF) values measured using the In-check-inspiratory flow meter. Dyspnea intensity was evaluated after a 1000 m test race using a labeled visual analog scale for dyspnea.

RESULTS

In relation to VO2max., when the participants used the experimental ENDS, significantly higher means were noted than when the placebo was used (53.0 ± 4.2 mL/kg min(-1) and 51.2 ± 5.5 mL/kg min(-1), respectively) (p<0.05). In relation to PNIF, there was a statistically significant difference between the experimental and placebo ENDS result, that being, 123 ± 38 L/min and 116 ± 38 L/min, respectively (p<0.05). The dyspnea perceived by the participants was representatively lesser in the experimental ENDS condition compared to the placebo after the cardio-respiratory test (p<0.05).

CONCLUSIONS

The results suggest that the ENDS improve maximal oxygen uptake, nasal patency and respiratory effort in healthy adolescent athletes after submaximal exercise.