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Nasalance and perceived voice changes in patients undergoing septoplasty and turbinate hypertrophy reduction

European Archives of Oto-Rhino-Laryngology(2021)

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Abstract
Purpose The purpose of this study was to investigate the changes in voice nasality after septoplasty and turbinate hypertrophy reduction and to evaluate the effect of these changes on patients’ voice-related quality of life. Methods Sixty patients with nasal obstruction symptoms caused by septal deviation and inferior turbinate hypertrophy who underwent septoplasty and inferior turbinate hypertrophy reduction and 25 healthy controls were included. Active anterior rhinomanometry and acoustic rhinometry were utilized for the evaluation of nasal patency and nasometry was used for quantitative assessment of nasalance. All participants completed validated questionnaires for assessing nasal obstruction symptom severity, psychological status and the impact of voice performance on their quality of life preoperatively and 6 months after septoplasty. Results Patients presented preoperatively statistically significantly lower nasalance scores and higher VHI scores than controls ( p < 0.05). Septoplasty and inferior turbinate hypertrophy reduction led to improvement of nasalance for the nasal text and the physical subscale of the VHI scores. Postoperatively, there were no statistically significant differences in nasalance and VHI scores between patients and controls. Significant correlations were found only for the baseline and the postoperative nasalance scores for the nasal text and the total nasal cavity volume ( p < 0.05). Postoperatively, patients who presented significant improvement of nasal obstruction symptoms and resolution of stress levels were more likely to positively evaluate the impact of their voice quality on their daily life (OR: 2.32, 95% CI 1.08–5.15, p = 0.041 and OR: 3.06, 95% CI 1.15–7.04, p = 0.038, respectively). Conclusion Septoplasty and inferior turbinate hypertrophy reduction may increase the nasal resonance, but in the long term, this change appears not to be significant enough. The severity of nasal obstruction symptoms and psychological status mainly affect the patients’ perceptual assessment regarding the effect of voice performance on their quality of life.
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Key words
Septoplasty, Nasalance, Nasal cavity, Voice, Quality of life, Voice handicap index
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