Abstract
Sinus surgery procedures such as sinus lifting with bone grafting or maxillary functional endoscopy surgery (FESS) can present different complications. The aims of this systematic review are to compile the post-operatory complications of sinus elevation with bone grafting and FESS including voice changes, and to elucidate if those changes are either permanent or temporary. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used, and the literature was exhaustively searched without time restrictions for randomized and non-randomized clinical studies, cohort studies (prospective and retrospective), and clinical case reports with ≥4 cases focused on sinus lift procedures with bone grafts and functional endoscopic maxillary sinus surgery. A total of 435 manuscripts were identified. After reading the abstracts, 101 articles were selected to be read in full. Twenty articles that fulfilled the inclusion criteria were included for analysis. Within the limitations of this systematic review, complications are frequent after sinus lifting with bone grafts and after FEES. Voice parameters are scarcely evaluated after sinus lifting with bone grafts and no voice changes are reported. The voice changes that occur after FESS include a decreased fundamental frequency, increased nasality, and nasalance, all of which are transitory.
Highlights
The human voice is an air-driven, vibration-produced, and resonance-enhanced phenomenon that requires the concurrent work of practically all of the body [1]
The F0 is defined as the mean frequency produced by the vibration of the vocal folds [6,7]; the cepstral peak prominence (CPP) evaluates the periodicity in the frequency and helps in determining the voice pitch or its perturbations [8]; jitter measures the fluctuations of the voice frequency, jitta measures the change in timbre in voice over short periods, and shimmer measures the amplitude of the peak-to-peak frequency during the voice cycle [9]
A PICOT format including population, intervention, comparison, outcome, and time was used to answer the following research questions: “Which are the post-operative complications of sinus floor elevation with bone grafts and functional endoscopic maxillary sinus surgery? Are voice changes reported within the complications of sinus surgery? What types of voice changes are reported, and are the changes transitory or permanent?
Summary
The human voice is an air-driven, vibration-produced, and resonance-enhanced phenomenon that requires the concurrent work of practically all of the body [1]. Echternach et al described the three elements that produce the voice: “air source (lungs, trachea, and larynx), voice/sound source (vocal folds), and the modification system (vocal and nasal tract).” [2] The characteristic features of the voice are defined by changes in those components or their interactions [2]. The analysis of the individual normal voice characteristics and their changes requires the measurement of at least six sound parameters, including the following: F0, cepstral peak prominence (CPP), jitter, jitta, and shimmer, and noise-to-harmonic ratio (HNR) [4,5]. The F0 is defined as the mean frequency produced by the vibration of the vocal folds [6,7]; the CPP evaluates the periodicity in the frequency and helps in determining the voice pitch or its perturbations [8]; jitter measures the fluctuations of the voice frequency, jitta measures the change in timbre in voice over short periods, and shimmer measures the amplitude of the peak-to-peak frequency during the voice cycle [9]. The HNR ratio evaluates the periodic and aperiodic components of the speech signal and reflects the airflow efficiency in producing vibration of the vocal folds [10,11]
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