Abstract
IntroductionAdenotonsillectomy is the most common surgery performed by otolaryngologists in pediatric age, and one of the most frequently asked questions about the postoperative period is whether there is a potential for change in vocal pattern of these children. ObjectiveTo evaluate the impact of adenotonsillectomy in the voice emission pattern of children with hypertrophy of palatine and pharyngeal tonsils. MethodsThis is a prospective study in which we carried out perceptual auditory assessments and acoustic analysis of 26 children with adenotonsillar hypertrophy at three time points: before surgery, one month and three months after surgery. The following acoustic parameters were estimated using the Praat software: fundamental frequency, jitter, shimmer, and harmonic–noise ratio. ResultsA statistically significant change was found between shimmer and harmonic–noise ratio during vowel /u/ production between the preoperative and 1st month postoperative time points. No significant differences were detected for acoustic parameters between preoperative analysis and that of the 3rd month post-operation. ConclusionTransient changes in acoustic parameters occur in children with adenotonsillar hypertrophy submitted to adenotonsillectomy, progressing to normalization in the 3rd postoperative month.
Highlights
Adenotonsillectomy is the most common surgery performed by otolaryngologists in pediatric age, and one of the most frequently asked questions about the postoperative period is whether there is a potential for change in vocal pattern of these children
The voice is basically a product of three physiological processes: a constant expiratory airflow controlled by chest muscles; production of glottal sound through vibration of the vocal folds, and a change in this sound with amplification and muffling of sound frequencies resulting from the action of pharyngeal, oral and nasal resonant structures.[1]
By applying the Wilcoxon test using Bonferroni correction, we found a statistically significant difference between the assessment carried out at the 1st month after the surgery and that undertaken in the 3rd month postoperatively (p = 0.005) and a trend showing that the time points before the surgery and at 1 month postoperatively are statistically different (Table 2)
Summary
Adenotonsillectomy is the most common surgery performed by otolaryngologists in pediatric age, and one of the most frequently asked questions about the postoperative period is whether there is a potential for change in vocal pattern of these children. According to Mora et al, hypertrophic palatine tonsils reduce the oropharyngeal air space and push the tongue forward, causing mouth breathing, abnormal nasality and a muffled voice.[2] It is reported that adenoid and tonsil hypertrophy cause obstruction of the nasopharyngeal region and a decreased mobility of velopharyngeal muscles (i.e. soft palate).[2]. It is the most studied, nasality is not the only form of voice alteration that can occur after adenotonsillectomy. There can be changes in voice quality due to phonation instability, as a consequence of changes in the vibration pattern of the vocal folds.[2,3]
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