Abstract
Adenotonsillectomy is one of the most common pediatric surgical procedures. Postoperative voice changes are a very common concern among patient's parents. Therefore, the aim of this study is to analyze acoustic voice parameters after adenotonsillectomy, tonsillectomy, and adenoidectomy in pediatric patients in a tertiary referral academic center. All pediatric patients undergoing an adenotonsillectomy, tonsillectomy or adenoidectomy in a single center from 2002 to 2018 were included in the study. Change of fundamental frequency, jitter, shimmer, and harmonic-noise ratio at first, seventh and 30th postoperative day compared to preoperative values were the primary outcome parameters. Statistical analysis was performed using repeated measures analysis of variance model. A total of 1258 patients were included in the study. The mean age of patients at the time of surgery was 8.3 years (range 3.0-18.0 years). Around 698 were male (55.5%) and 560 female (44.5%). The values of fundamental frequency increased significantly after the first and seventh postoperative day (P=0.001 both) but normalized 1 month after surgery (P=0.962). At the first postoperative month, values of jitter and shimmer decreased significantly (P=0.005 and P=0.002, respectively). Measurements of harmonic-noise ratio revealed a significant increase 30 days after surgery (P=0.004). Statistically significant differences in objective voice parameters within the first postoperative month after tonsillectomy, adenoidectomy, and adenotonsillectomy were observed. The fundamental frequency returned to normal 1 month after surgery. These findings can contribute in soothing the concerns of parents regarding postoperative voice changes.
Highlights
Adenotonsillectomy is one of the most common surgical procedures in medicine and certainly the most prevalent one in pediatric otorhinolaryngology
Demographics A total of 1258 patients undergoing an adenotonsillectomy, tonsillectomy, or adenoidectomy were included in the study
Measurements of shimmer revealed no statistically significant differences between preoperative measurements and values on the first or seventh postoperative day (GMR = 0.94, 95% confidence intervals (CI): 0.88−1.01, P = 0.080; and geometric mean ratios (GMR) = 0.95, 95% CI: 0.89−1.02, P = 0.199, respectively)
Summary
Adenotonsillectomy is one of the most common surgical procedures in medicine and certainly the most prevalent one in pediatric otorhinolaryngology. It is associated with a low complication rate.[1] a commonly raised concern of parents in pediatric adenotonsillectomy is the effect of surgery on voice patterns which might be transient or persisting.[2]. The tonsils and adenoids are located in the vocal tract They can reduce the air space hindering the production of sound and change the quality of the voice.[3] Most of currently available data focus on the effect of adenotonsillectomy on subjective speech measures, such as nasality and perceptual-auditory voice parameters. Objective changes of the vocal cords vibration patterns after removal of a significant volume from the oropharyngeal and epipharyngeal space leading to phonation instability have been
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