Beyhan YILMAZ, Engin ŞENGÜL, Musa ÖZBAY, Salih BAKIR

Adenotonsillektominin Akustik, Algısal ve Aerodinamik Ses Parametrelerine Etkisi

Amaç: Bu çalışmada, adenotonsillektomi ameliyatının sesin akustik, algısal ve aerodinamik parametreleri üzerine olan etkilerinin objektif yöntemler ile araştırılması amaçlanmıştır.Yöntemler: Çalışmaya adenotonsillektomi ameliyatı yapılan 30 çocuk hasta katılmıştır. Ses analizleri operasyondan 1 gün önce ve 1 ay sonra olmak üzere 2 kez yapılmıştır. Ses analiz programı olarak LingWAVES kullanılmıştır. Ortalama temel frekans, Maksimum temel frekans, Minimum temel frekans, Jitter, Shimmer, Glottal to Noise Excitation, S time, Z time, S/Z ratio ve Maximum Phonation Time parametreleri karşılaştırılmıştır.Bulgular: Shimmer, irregularity, Overall Severity, S/Z Time parametrelerinin postoperatif değerleri preoperatif döneme göre anlamlı olarak daha düşük (p=0,001), Maximum Phonation Time parametresi ise anlamlı olarak daha yüksek (p=0,001) izlenmiştir. Buna karşılık Ortalama temel frekans, Maksimum temel frekans, Minimum temel frekans, Jitter, Glottal to Noise Excitation, S time, ve Z time parametrelerinde anlamlı farklılık izlenmemiştir (p>0,05).Sonuç: Adenotonsillektomi sonrası bazı akustik, aerodinamik ve algısal ses parametrelerinde değişiklikler izlenmiştir. Bu nedenle adenotonsillektomi yapılacak çocukların aileleri cerrahi sonrası gelişebilecek muhtemel ses rengi değişikliklerine karşın bilgilendirilmelidirler.

Effects of Adenotonsillectomy on Acoustic, Perceptual, and Aerodynamic Parameters of Voice

Objective: In this study, we aimed to investigate the acoustic, perceptual and aerodynamic changes of voice after adenotonsillectomy by using objective methods.Methods: Thirty children, who underwent adenotonsillectomy surgery were included. Voice samples were recorded 1 day before and 1 month after the surgery. LingWAVES programme was used as voice analysis program. Mean, maximum and minimum fundamental frequency, Jitter, Shimmer, Glottal to Noise Excitation ratio, Irregularity, Noise, Overall Severity, S time, Z time, S/Z ratio, and Maximum Phonation Time parameters were recorded and compared.Results: Shimmer, irregularity, Overall Severity, S/Z Time parameters were significantly lower (p=0.001) and Maximum Phonation Time significantly higher (p=0.001) in the postoperative period than preoperative period. In contrast, no significant differences were observed in the mean fundamental frequency, maximum fundamental frequency, minimum fundamental frequency, jitter, Glottal to Noise Excitation, S time and Z time (p>0.05).Conclusion: The changes in some acoustic, aerodynamic and perceptual parameters were monitored after adenotonsillectomy. Therefore, the families of children who underwent adeotonsillectomy should be warned for any possible changes in voice colors after surgery.

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1. Chuma AV, Cacace AT, Rosen R, et al. Effects of tonsillectomy and/or adenoidectomy on vocal function: laryngeal, supralaryngeal and perceptual characteristics. Int J Pediatric Otolaryngol 1999;47:1-9.
2. Sarıca S. Ses Analizinde Kullanılan Akustik Parametreler. Tıpta Uzmanlık Tezi 2012;37-45.
3. Oğuz H, Kılıç MA, Şafak MA. Comparison of results in two acoustic analysis programs: Praat and MDVP. Turk J Med Sci 2011;41:835-841.
4. Amir O, Ashkenazi O, Leibovitzh T. Applying the Voice Handicap Index (VHI) to Dysphonic and Non dysphonic Hebre 3w Speakers. J Voice 2006;18:71-82.
5. Samian RA. Ses analizi. Ed: Cummings CW, Flint PW, Harker LA, ve ark. Cummings Otolaringoloji Baş ve Boyun Cerrahisi. (Çev: Koç C.) s. 2008-25, Cilt 3, 4. Basım, Gü- neş Tıp Kitabevi, Ankara, 2007.
6. Kılıç MA, Okur E, Yıldırım İ. Ses handikap endeksi Türkçe versiyonun güvenilirliği ve geçerliliği. KBB İhtisas Dergisi 2008;18:139-147.
7. Kılıç MA. Evaluation of the patient with voice problem by objective and subjective methods. Curr Prac J Voice. 2007;21:576-590.
8. Karnell MP, Melton SD, Childes JM, et al. Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders. J Voice. 2007;21:576-590.
9. Nemr K, Simões-Zenari M, Cordeiro GF, et al. GRBAS and Cape-V scales: high reliability and consensus when applied at different times. J Voice 2012;26:17-22.
10. Henry LR, Helou LB, Solomon NP, et al. Functional voice outcomes after thyroidectomy: An assessment of the Dsyphonia Severity Index (DSI) after thyroidectomy. Surgery 2010;147:861-870.
11. Michaelis D, Fröhlich M, Strube HW. Selection and combination of acoustic features for the description of pathologic voices. J Acoust Soc Am 1998;103:1628-1639.
12. Fröhlich M, Michaelis D, Strube HW, Kruse E. Acoustic voice analysis by means of the hoarseness diagram. J Speech Lang Hear Res 2000;43:706-720.
13. Lundeborg I, Hultcrantz E, Ericsson E, McAllister A. Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy--effects of surgery. J Voice 2012;26:480-487.
14. Mora R, Crippa B, Dellepiane M, Jankowska B. Effects of adenotonsillectomy on speech spectrum in children. Int J Pediatr Otorhinolaryngol 2007;71:1299-1304.
15. Kandoğan T, Özüer MZ. Effects Of Tonsıllectomy On Acoustıc Parameters. Kbb-Forum 2006;5.
16. Subramaniam V, Kumar P. Impact of tonsillectomy with or without adenoidectomy on the acoustic parameters of the voice: a comparative study. Arch Otolaryngol Head Neck Surg 2009;135:966-969.
17. Dimatos SC, Neves LR, Beltrame JM, et al. Impact of adenotonsillectomy on vocal emission in children. Braz J Otorhinolaryngol. 2016;82:151-158.