OpenLB
Open Library of Bioscience
Advanced Search
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
Mar 18, 2025;

The Effect of Concomitant Septoplasty and Turbinate Surgery on Nasality-Related Voice Parameters.

Cevat Celenk, Burak Ulkumen, Onur Celik
Author Information
  1. Cevat Celenk: Otorhinolaryngology Clinic, Manisa City Hospital, Manisa, Turkey.
  2. Burak Ulkumen: Faculty of Medicine, Otorhinolaryngology Department, Manisa Celal Bayar University, Manisa, Turkey. ORCID
  3. Onur Celik: Faculty of Medicine, Otorhinolaryngology Department, Manisa Celal Bayar University, Manisa, Turkey.
PMID: 40103316 DOI: 10.1111/coa.14304

Abstract

INTRODUCTION: Our study aimed to reveal whether septoplasty and inferior turbinate reduction significantly impact the acoustic properties of nasalized syllables and alter subjective and objective voice parameters.
MATERIALS AND METHODS: Forty patients with nasal septal deviation and bilateral grade 2���������inferior turbinate hypertrophy who underwent septoplasty and bilateral inferior turbinoplasty were enrolled. Participants completed the VHI-10, VAS, and NOSE scales preoperatively and at 6���months postoperatively. Changes in VAS and NOSE scores were calculated as VAS and NOSE values. Voice recordings of the sustained vowel /a/ and the word /mini/ were analysed using MDVP. Acoustic analysis was performed with the sustained vowel /a/, and spectrographic analysis was conducted with the consonants /m/, /n/, and the vowel /i/ in /mini/. Recordings were taken preoperatively and at 6���months postoperatively. Statistical analysis compared pre- and postoperative values for significant changes using SPSS Version 21.0 (IBM Corp.; Armonk, NY, USA).
RESULTS: A statistically significant decrease in VAS and NOSE scores was observed at 6���months postoperatively (p���<���0.05). No significant difference was found in VHI-10 scores (p���>���0.05). Acoustic analysis showed a significant change in pre- and postoperative F0 values (p���<���0.05), but not in jitter, jitter%, shimmer, shimmer%, and NHR (p���>���0.05). Spectrographic analysis revealed significant postoperative changes in the F3 and F4 formants of consonants /m/, /n/, and vowel /i/ in the word /mini/. A significant correlation was found between postoperative changes in F3 and F4 formant values for consonants /m/ and /n/ with the VAS value. For the NOSE value, a significant correlation was found only with the change in the F3 formant value for the consonant /m/.
CONCLUSION: Nasal surgeries, particularly septo-turbinoplasty, can influence voice timbre by modifying F3 and F4, which is of notable concern for professional voice users, such as singers and actors, due to the potential impact on the singer's formant cluster and overall vocal quality. Although it may not be appropriate to generalise for all rhinological surgeries, the significant changes in the F3 and F4 formants in a specific and refined patient group suggest that caution should be exercised in such surgeries, especially for professional voice users.

Keywords

acoustic analysis septoplasty spectrography turbinoplasty voice

References

  1. T. Vampola, J. Hor����ek, V. Radolf, J. G. ��vec, and A. M. Laukkanen, ���Influence of Nasal Cavities on Voice Quality: Computer Simulations and Experiments,��� Journal of the Acoustical Society of America 148, no. 5 (2020): 3218���3231, https://doi.org/10.1121/10.0002487.
  2. B. Geng, Q. Xue, and X. Zheng, ���The Effect of Vocal Fold Vertical Stiffness Variation on Voice Production,��� Journal of the Acoustical Society of America 140, no. 4 (2016): 2856���2866.
  3. J. G. ��vec, H. K. Schutte, C. J. Chen, and I. R. Titze, ���Integrative Insights Into the Myoelastic���Aerodynamic Theory and Acoustics of Phonation Scientific Tribute to Donald G. Miller,��� Journal of Voice 37, no. 3 (2023): 305���313, https://doi.org/10.1016/j.jvoice.2021.01.023.
  4. A. Salami, B. Jankowska, M. Dellepiane, B. Crippa, and R. Mora, ���The Impact of Tonsillectomy With or Without Adenoidectomy on Speech and Voice,��� International Journal of Pediatric Otorhinolaryngology 72 (2008): 1377���1384.
  5. R. Mora, B. Crippa, M. Dellepiane, and B. Jankowska, ���Effects of Adenotonsillectomy on Speech Spectrum in Children,��� International Journal of Pediatric Otorhinolaryngology 71 (2007): 1299���1304.
  6. M. Y. Chen and R. Metson, ���Effects of Sinus Surgery on Speech,��� Archives of Otolaryngology ��� Head & Neck Surgery 123 (1997): 845���852.
  7. R. Mora, B. Jankowska, M. Dellepiane, et al., ���Acoustic Features of Voice After Septoplasty,��� Medical Science Monitor 15 (2009): 269���273.
  8. M. Jasim, V. G. Nayana, H. Nayaka, and P. S. Nayak, ���Effect of Adenotonsillectomy on Spectral and Acoustic Characteristics,��� Indian Journal of Otolaryngology and Head & Neck Surgery 75, no. 4 (2023): 3467���3475, https://doi.org/10.1007/s12070���023���03967���z.
  9. C. C. Xiao, F. S. Luetzenberg, N. Jiang, and J. Liang, ���Does Nasal Surgery Affect Voice Outcomes? A Systematic Review With Meta���Analyses,��� Annals of Otology, Rhinology and Laryngology 129, no. 12 (2020): 1174���1185, https://doi.org/10.1177/0003489420933290.
  10. L. J. B��ck, M. L. Hyt��nen, H. O. Malmberg, and J. S. Ylikoski, ���Submucosal Bipolar Radiofrequency Thermal Ablation of Inferior Turbinates: A Long���Term Follow���Up With Subjective and Objective Assessment,��� Laryngoscope 112, no. 10 (2002): 1806���1812, https://doi.org/10.1097/00005537���200210000���00019.
  11. E. A. ��zbal Ko��, B. Ko��, I. Ercan, I. Kocak, E. Tadihan, and S. Turgut, ���Effects of Septoplasty on Speech and Voice,��� Journal of Voice 28, no. 3 (2014): 393.
  12. L. A. Pedersen, S. D��lvik, K. Holmberg, et al., ���Surgery to Relieve Nasal Obstruction: Outcome for 366 Patients Operated on by One Senior Surgeon,��� European Archives of Oto���Rhino���Laryngology 278, no. 10 (2021): 3867���3875, https://doi.org/10.1007/s00405���021���06696���7.
  13. P. J. Bousquet, C. Combescure, F. Neukirch, et al., ���Visual Analog Scales Can Assess the Severity of Rhinitis Graded According to ARIA Guidelines,��� Allergy 62, no. 4 (2007): 367���372.
  14. M. G. Stewart, D. L. Witsell, T. L. Smith, E. M. Weaver, B. Yueh, and M. T. Hannley, ���Development and Validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale,��� Otolaryngology and Head and Neck Surgery 130, no. 2 (2004): 157���163.
  15. R. H. Shukla, S. V. Nemade, and K. J. Shinde, ���Comparison of Visual Analogue Scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) Score in Evaluation of Post Septoplasty Patients,��� World Journal of Otorhinolaryngology ��� Head and Neck Surgery 6, no. 1 (2020): 53���58.
  16. J. C. Sowder, A. J. Thomas, and P. D. Ward, ���Essential Anatomy and Evaluation for Functional Rhinoplasty,��� Facial Plastic Surgery Clinics of North America 25, no. 2 (2017): 141���160, https://doi.org/10.1016/j.fsc.2016.12.001.
  17. Y. Liu, S. A. S. Lee, and W. Chen, ���The Correlation Between Perceptual Ratings and Nasalance Scores in Resonance Disorders: A Systematic Review,��� Journal of Speech, Language, and Hearing Research 65, no. 6 (2022): 2215���2234, https://doi.org/10.1044/2022_JSLHR���21���00588.
  18. K. H. Hong, S. H. Kwon, and S. S. Jung, ���The Assessment of Nasality With a Nasometer and Sound Spectrography in Patients With Nasal Polyposis,��� Otolaryngology and Head and Neck Surgery 117, no. 4 (1997): 343���348.
  19. A. am Zehnhoff���Dinnesen, B. Wiskirska���Wo��nica, K. Neumann, and T. Nawka, Phoniatrics I. Fundamentals ��� Voice Disorders ��� Disorders of Language and Hearing Development (Springer, 2020), 2626���7853, https://doi.org/10.1007/978���3���662���46780���0.
  20. G. S. Lee, C. C. Yang, C. P. Wang, and T. B. Kuo, ���Effect of Nasal Decongestion on Voice Spectrum of a Nasal Consonant���Vowel,��� Journal of Voice 19, no. 1 (2005): 71���77, https://doi.org/10.1016/j.jvoice.2004.03.002.
  21. Y. Wang, M. Hattori, K. Masaki, and Y. I. Sumita, ���Detailed Speech Evaluation Including Formant 3 Analysis and Voice Visualization in Maxillofacial Rehabilitation: A Clinical Report,��� Journal of Prosthetic Dentistry 132, no. 6 (2024): 1331.e1���1331.e7, https://doi.org/10.1016/j.prosdent.2023.02.022.
  22. Y. H. Kim, S. H. Lee, C. W. Park, and J. H. Cho, ���Nasalance Change After Sinonasal Surgery: Analysis of Voice After Septoturbinoplasty and Endoscopic Sinus Surgery,��� American Journal of Rhinology & Allergy 27, no. 1 (2013): 67���70, https://doi.org/10.2500/ajra.2013.27.3832.
  23. B. Y. Kim, J. H. Shin, S. W. Kim, et al., ���Hypernasality After Using the Endoscopic Endonasal Transsphenoidal Approach for Skull Base Tumors,��� Laryngoscope 126, no. 2 (2016): 329���333, https://doi.org/10.1002/lary.25450.
  24. K. L. Yang, S. D. Luo, M. H. Tsai, Y. Chang, H. Y. Kuo, and W. C. Chen, ���Nasality Outcome in Unilateral Chronic Rhinosinusitis Following Functional Endoscopic Sinus Surgery,��� Journal of the Formosan Medical Association 121, no. 5 (2022): 936���942, https://doi.org/10.1016/j.jfma.2021.06.030.
  25. P. Kasemsiri, P. Duangthongphon, B. Prathanee, and C. Thongrong, ���Nasal Resonance Changes After Endoscopic Endonasal Transsphenoidal Skull Base Surgery: Analysis of Voice Quality,��� Laryngoscope Investigative Otolaryngology 6, no. 6 (2021): 1275���1282, https://doi.org/10.1002/lio2.701.
  26. M. Bakhshaee, M. Jahanian, K. Khazaeni, D. Sobhani, L. Mashhadi, and B. Rasoulian, ���Potential Effects of Rhinoplasty on Voice in Professional Voice Users,��� Aesthetic Plastic Surgery 45, no. 5 (2021): 2280���2286, https://doi.org/10.1007/s00266���021���02250���2.
  27. A. E. G��ker, ��. Aydo��du, Z. Salt��rk, et al., ���Comparison of Voice Quality Between Patients Who Underwent Inferior Turbinoplasty or Radiofrequency Cauterization,��� Journal of Voice 31, no. 1 (2017): 121.e17���121.e21, https://doi.org/10.1016/j.jvoice.2016.02.002.
  28. S. Gulec, I. Kulahli, M. I. Sahin, et al., ���Effect of Septoplasty on Voice Quality: A Prospective���Controlled Trial,��� Clinical and Experimental Otorhinolaryngology 9, no. 3 (2016): 238���243, https://doi.org/10.21053/ceo.2015.01354.
  29. V. Subramaniam, R. Yoonus, and M. Narra, ���Effects of Septoplasty on the Acoustic Parameters of Voice,��� Egyptian Journal of Ear, Nose, Throat and Allied Sciences 16, no. 3 (2015): 259���263.
  30. E. Apayd��n, A. ��kincio��ullar��, M. ��olak, D. Atan, S. Ensari, and H. H. Dere, ���The Voice Performance After Septoplasty With Surgical Efficacy Demonstrated Through Acoustic Rhinometry and Rhinomanometry,��� Journal of Voice 34, no. 4 (2020): 649.e15���649.e20, https://doi.org/10.1016/j.jvoice.2019.01.008.
  31. M. Camacho, S. Zaghi, V. Certal, et al., ���Inferior Turbinate Classification System, Grades 1 to 4: Development and Validation Study,��� Laryngoscope 125, no. 2 (2015): 296���302, https://doi.org/10.1002/lary.24923.
  32. B. Ulkumen, B. Artunc���Ulkumen, and O. Celik, ���Impact of Pregnancy on Voice: A Prospective Observational Study,��� Logopedics, Phoniatrics, Vocology 47, no. 3 (2021): 183���188, https://doi.org/10.1080/14015439.2021.1903076.
  33. B. Ulkumen, B. A. Ulkumen, H. G. Pala, et al., ���Pregnancy Rhinitis in Turkish Women: Do Gestational Week, BMI and Parity Affect Nasal Congestion?,��� Pakistan Journal of Medical Sciences 32, no. 4 (2016): 950���954, https://doi.org/10.12669/pjms.324.10164.
  34. J. P. Teixeira, C. Oliveira, and C. Lopes, ���Vocal Acoustic Analysis ��� Jitter, Shimmer and HNR Parameters,��� Procedia Technology 9 (2013): 1112���1122, https://doi.org/10.1016/j.protcy.2013.12.124.
  35. L. H. Haavisto, T. J. Vahlberg, and J. I. Sipila, ���Correlation Between Acoustic Rhinometry and Visual Analogue Scale in Children With No Nasal Symptoms: A Prospective Cohort Study,��� Clinical Otolaryngology 36, no. 2 (2011): 129���133.
  36. M. Havel, L. Ertl, D. Bauer, M. Schuster, K. Stelter, and J. Sundberg, ���Resonator Properties of Paranasal Sinuses: Preliminary Results of an Anatomical Study,��� Rhinology 52, no. 2 (2014): 178���182, https://doi.org/10.4193/Rhino13.097.
  37. K. Valsamidis, A. Printza, J. Constantinidis, A. Okalidou, and S. Triaridis, ���Nasalance and Perceived Voice Changes in Patients Undergoing Septoplasty and Turbinate Hypertrophy Reduction,��� European Archives of Oto���Rhino���Laryngology 279, no. 4 (2022): 1899���1910, https://doi.org/10.1007/s00405���021���06937���9.
  38. D. Atan, K. M. ��zcan, A. B. T. G��rb��z, and H. Dere, ���The Effect of Septoplasty on Voice Performance in Patients With Severe and Mild Nasal Septal Deviation,��� Journal of Craniofacial Surgery 27, no. 5 (2016): 1162���1164.
  39. C. Ersoz Unlu and O. Akkoca, ���The Effect of Nasal Septum Deviation on Voice Aging,��� Logopedics, Phoniatrics, Vocology 47, no. 3 (2022): 189���193, https://doi.org/10.1080/14015439.2021.1904285.
  40. B. Abdullah and S. Singh, ���Surgical Interventions for Inferior Turbinate Hypertrophy: A Comprehensive Review of Current Techniques and Technologies,��� International Journal of Environmental Research and Public Health 18, no. 7 (2021): 3441, https://doi.org/10.3390/ijerph18073441.
  41. T. Fattahi and F. Quereshy, ���Septoplasty: Thoughts and Considerations,��� Journal of Oral and Maxillofacial Surgery 69, no. 12 (2011): e528���e532, https://doi.org/10.1016/j.joms.2011.08.001.
  42. E. A. Ozbal Koc, B. Koc, I. Ercan, I. Kocak, E. Tadihan, and S. Turgut, ���Effects of Septoplasty on Speech and Voice,��� Journal of Voice 28, no. 3 (2014): 393.e11���393.e15, https://doi.org/10.1016/j.jvoice.2013.09.008.
Journal Article

Word Cloud

Created with Highcharts 10.0.0significantanalysisvoiceVASNOSEF3valuesvowel/m/postoperativechanges05F4septoplasty6���monthspostoperativelyscores/mini/consonants/n/foundformantvaluesurgeriesinferiorturbinateimpactacousticbilateralturbinoplastyVHI-10preoperativelyVoicesustained/a/wordusingAcoustic/i/pre-p���<���0p���>���0changeformantscorrelationprofessionalusersINTRODUCTION:studyaimedrevealwhetherreductionsignificantlypropertiesnasalizedsyllablesaltersubjectiveobjectiveparametersMATERIALSANDMETHODS:Fortypatientsnasalseptaldeviationgrade2���������inferiorhypertrophyunderwentenrolledParticipantscompletedscalesChangescalculatedrecordingsanalysedMDVPperformedspectrographicconductedRecordingstakenStatisticalcomparedSPSSVersion210IBMCorpArmonkNYUSARESULTS:statisticallydecreaseobserveddifferenceshowedF0jitterjitter%shimmershimmer%NHRSpectrographicrevealedconsonantCONCLUSION:Nasalparticularlysepto-turbinoplastycaninfluencetimbremodifyingnotableconcernsingersactorsduepotentialsinger'sclusteroverallvocalqualityAlthoughmayappropriategeneraliserhinologicalspecificrefinedpatientgroupsuggestcautionexercisedespeciallyEffectConcomitantSeptoplastyTurbinateSurgeryNasality-RelatedParametersspectrography

Similar Articles

Cited By

No available data.