Evaluation of some velar functions before and after surgical treatment of snoring

The effects of uvulopalatal flap operation on speech nasalance and the acoustic parameters of the final nasal consonants

OBJECTIVE

The acoustic characteristics of voice are determined by the source of the sound and shape of the vocal tract. Various anatomical changes after uvulopalatal flap (UPF) operation can change nasalance and/or other voice characteristics. Our aim was to explore the possible effects of UPF creation on speech nasalance and the resonatory features of the final nasal consonants, and thus voice characteristics.

METHODS

A total of 30 patients (26 males, 4 females) with obstructive sleep apnea who underwent UPF operation were recruited. A Nasometer II 3.4 instrument was used to assess nasalance pre- and post-operatively; the patients read standard Korean passages and the readings were recorded in Computer Speech Laboratory for later spectral analysis. Praat software was used to identify frequency bands affecting perioperative nasalance scores. Minima, maxima, and slopes were analyzed.

RESULTS

We found no significant correlation between nasalance scores (any passage) and the respiratory distress index or body mass index. No significant perioperative change in any nasalance score. The moment variations in the final consonants /m/ and /n/ did not change significantly postoperatively. However, the postoperative moment variation of the final consonant /ng/ differed significantly in the third formant (F3) and second bandwidth (BW2).

CONCLUSION

Few significant changes in nasal resonance speech quality were apparent after UPF operation. However, a postoperative acoustic change in the final sound /ng/ may be sustained. Patients may be preoperatively advised that the risk of voice change is very low, but not absent.

Changes in the nasalance of vowels within the first week following uvulopalatopharyngoplasty

We conducted a retrospective study to evaluate the short-term effect of uvulopalatopharyngoplasty (UPPP) on changes in the nasalance of five vowels: /a/, /ε/, /i/, /ɔ/, and /u/. Our study group was made up of 20 patients-15 males and 5 females, aged 16 to 57 years (mean: 37.3 ± 11.5)-who had undergone UPPP as a treatment for mild to moderate obstructive sleep apnea. Nasometry was used to obtain nasalance scores in all patients on the morning of the operation (day 1) and subsequently on day 4 or 5 (mean: 4.5 ± 0.5). Preoperatively, nasalance scores were highest for /i/ (mean: 29.8 ± 12.6) and /a/ (mean: 24.1 ± 10.3). After the operation, nasalance scores for all five studied vowels increased; they were highest for /i/ (mean: 40.7 ± +17.8) and /ε/ (mean: 30.0 ± 10.8). The increases in the nasalance of /i/, /ε/, and /u/ were statistically significant (p < 0.05). Our findings indicate that UPPP has a significant impact on nasalance immediately after surgery.

Impact of obturation of palatal fistulae on speech quality and aerodynamic parameters in patients with cleft palates

OBJECTIVES

The aim of this prospective study was to measure nasal and oral airflow during speech, before and after obturation.

PATIENTS AND METHODS

Included were children aged 3-18 years with nonsyndromic clefts and palatal fistulae. The corpus used was: syllable /pi/; a sentence containing stop consonants and a nasal phoneme; and the description of a picture of a scene. Analysis criteria were: percentage of nasality; value of average flow for the explosion; perceived nasality and intelligibility; and tolerance of the proposed device.

RESULTS

Only 5 children were included due to the observation of an increase in the percentage of nasality after obturation. The value of average flow for the explosion increased in all patients. A decrease in perceived nasality was noted in all but 1 patient. An improvement in intelligibility was observed in 3 out of the 5 children. The tolerance of the device was good.

CONCLUSION

While the small number of patients studied does not permit firm conclusions concerning the efficiency of the obturation, the method described, as well as the introduction of 'speed of explosion' of stop consonants, offer new perspectives to prospectively study obturator effects on speech.

Nasalance, nasality, voice, and articulation after uvulopalatopharyngoplasty

OBJECTIVES/HYPOTHESIS

The main purpose of the study was to determine the impact of uvulopalatopharyngoplasty (UPPP) on nasalance and nasality. It was hypothesized that nasalance would change from the presurgical to the postsurgical condition because the surgical protocol involves removal of palatal tissue. An additional objective of the study was to provide objective and subjective data about changes in voice and articulation after UPPP. Because the surgical procedure of UPPP does not involve laryngeal tissue, it was hypothesized that the voice characteristics remain relatively stable. Because of removal of effective velar length, articulation problems of the uvular /R/ can occur in the Dutch language.

STUDY DESIGN

Prospective study in which 26 men were studied before (1 week before UPPP) and after (3 weeks after UPPP) surgery.

METHODS

The Nasometer was used to obtain nasalance scores. The mirror-fogging test, a perceptual evaluation of each subject's readings, and the Gutzmann and the Bzoch hypernasality tests were used for the assessment of nasality. For the assessment of articulation, a phonetic analysis was performed. Voice assessment included a perceptual rating of the voice and a determination of fundamental frequency.

RESULTS

No significant differences were found between the conditions before and after surgery regarding nasalance (except for the vowel /i/), nasality, and voice. Regarding articulation, only 1 patient showed a derhotacized /R/.

CONCLUSIONS

The findings of the study indicate that UPPP does not have an impact on nasality, voice, and articulation. Regarding nasalance, no significant nasalance change occurred after UPPP, except for the high vowel /i/.