title: Changes in nasal resonance following septoplasty in adults: Acoustic and perceptual characteristics.
abstract: OBJECTIVE
  Patients undergoing surgery for a deviated nasal septum (septoplasty) often report that their voice sounds different or less hyponasal. However, such a relationship between septoplasty and vocal resonance remains without scientific evidence. The purpose of this work is to investigate whether nasal septal surgery has any effect on nasal resonance, both in terms of objective measurements and patient perception.
  
  
  METHODS
  The research carried out was a prospective case-control study. We recruited patients who underwent septoplasty (study group) and healthy volunteers (control group). We obtained voice recordings of the nasal consonant /m/ pre- and four weeks postoperatively and twice at similar time intervals in the control group. We investigated objective changes by means of acoustic analysis of the voice recordings and calculated the total amount of acoustic energy in different bandwidths on a wide-band spectrogram. We also utilized a questionnaire to explore patient perception.
  
  
  RESULTS
  A total of 34 participants entered the study. ANOVA testing revealed significant changes in average total acoustic energy, phlegm, and throat dryness postoperatively. Regarding patient perception, a considerable number of our patients felt that their voice had changed for the better upon direct questioning. However, statistical analysis of the questionnaire items related to nasality of voice did not show a significant change.
  
  
  CONCLUSIONS
  In this study it has been demonstrated that surgical correction of septal deviation causes significant spectrographic changes. In particular it causes changes in the average total acoustic energy during the production of a nasal consonant. A considerable number of our patients reported change in their vocal resonance for the better. We recommend that patients be advised that their voice may sound different after surgery, or less hyponasal.
authors.affiliation: a Department of Otolaryngology Head and Neck Surgery , 'Sotiria' General Hospital , Athens , Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Liapi
authors.affiliation: b Centre for Health Services Research, School of Health Services, City University , London , UK.
authors.forename: Shashivadan
authors.initials: S
authors.lastname: Hirani
authors.affiliation: c University College London Hospitals NHS Trust and University College London , London , UK.
authors.forename: John
authors.initials: J
authors.lastname: Rubin
mesh_terms: D000162:Acoustics; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000293:injuries / Q000601:surgery*; D009667:Nose Deformities, Acquired / Q000175:diagnosis / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000379:methods*; D012649:Self Concept; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014732:Vibration; D014833:Voice Quality; D055815:Young Adult
keywords: Acoustic analysis; nasal surgery; resonance; septoplasty; voice