The Effects of the Newest Palatopharyngeal Surgery (Barbed Pharyngoplasty) on Voice Quality

J Voice. 2023 Mar 24:S0892-1997(23)00033-4. doi: 10.1016/j.jvoice.2023.01.033. Online ahead of print.

Abstract

Objectives: This study aimed to examine the effects of barbed pharyngoplasty (BP) on voice quality in patients with Obstructive sleep apnea syndrome (OSAS) and to compare them with the anterior palatoplasty (AP) and expansion sphincter pharyngoplasty (ESP) surgeries.

Methods: The study included 329 patients who came to the Otorhinolaryngology Clinic of our hospital with symptoms of snoring and sleep apnea between January 2020 and 2022 and were referred to the sleep laboratory for polysomnography (PSG). AP surgery was recommended for those with retropalatal stenosis in the anteroposterior direction, and ESP surgery for those with lateral stenosis. BP was recommended for those with both anteroposterior and lateral retropalatal stenosis. 60 patients who met the study criteria were included in the study. All surgeries were performed under general anesthesia by the same otolaryngologist within 1 month at the latest after sleep endoscopy. Acoustic voice analysis was performed using the Praat voice analysis program preoperatively and postoperatively at 6 months. F0, jitter, shimmer, and NHR (noise-to-harmonic ratio) were compared between groups pre and postoperatively.

Results: F0 %, jitter %, shimmer %, and NHR % changes were highest in BP. Jitter, shimmer, and NHR decreased significantly in the BP group, whereas F0 increased significantly. Although the mean F0 increased in both AP and ESP groups, the greatest change was in the AP group following BP groups. Although the average jitter, shimmer, and NHR decreased in both groups, the greatest change was in the ESP group following BP groups.

Conclusion: In patients with OSAS, BP surgery changed F0, jitter, shimmer and NHR more than AP and ESP surgeries, and effected the voice quality more positively.

Keywords: Anterior palatoplasty—Functional expansion sphincter pharyngoplasty—Jitter; Noise to harmonic ratio—Shimmer—Voice analysis.