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CC BY-NC-ND 4.0 · International Journal of Practical Otolaryngology 2024; 07(01): e30-e37
DOI: 10.1055/s-0044-1791270
Original Article

Impact of Tonsillectomy and Associated Factors on Voice

Naoto Araki
1   Department of Otolaryngology, Okitama Public General Hospital, Yamagata, Japan
,
Shino Godo
1   Department of Otolaryngology, Okitama Public General Hospital, Yamagata, Japan
,
Yusuke Hirano
1   Department of Otolaryngology, Okitama Public General Hospital, Yamagata, Japan
,
Ryo Fukase
1   Department of Otolaryngology, Okitama Public General Hospital, Yamagata, Japan
,
Kazuya Kurakami
2   Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
,
Shinichi Sakurai
1   Department of Otolaryngology, Okitama Public General Hospital, Yamagata, Japan
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Abstract

Tonsillectomy is commonly performed to treat repetitive tonsillitis. Tonsillectomy changes the shape and characteristics of the pharynx. It could also alter the resonating characteristics of the pharynx and affect the voice of the patient. We examined voice changes in patients undergoing tonsillectomy. A total of 33 adult patients who underwent tonsillectomy at our institution between July 2020 and December 2021 were included in the study. The participants consisted of 16 men and 17 women, with a mean ± standard deviation age of 33.7 ± 10.7 years. We measured the maximum phonation time, acoustic analysis values (jitter%, shimmer%, and noise-to-harmonic ratio [NHR]), speaking fundamental frequency and vocal range, first four formants (F1–F4) in the sustained vowel /a/, and Voice Handicap Index (VHI). We examined whether any changes occurring 3 months after the surgery compared with the findings before the surgery. The shimmer% and NHR decreased significantly after surgery compared with the observations prior to surgery. Among women, the speaking fundamental frequency tended to increase, and the F2 significantly increased after the surgery compared with that prior to surgery. Removal of the swollen tonsils reduced the resistance of the supraglottic space and resulted in a lower laryngeal adduction force required for phonation. The decreases in the shimmer% and NHR were attributed to a reduction in the turbulence in the supraglottic space. The change in the shape of the pharynx caused changes in the speaking fundamental frequency and formants. The changes were thought to be influenced by the size of the patient's pharyngeal cavity, volume of the tonsils, and scarring of the pharyngeal mucosa. Patients should be informed before surgery of the possibility of voice changes.

Keywords

tonsillectomy - voice - pharynx - acoustic analysis - speaking fundamental frequency


Publication History

Received: 16 January 2024

Accepted: 09 May 2024

Article published online:
26 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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