Potential Effects of Rhinoplasty on Voice in Professional Voice Users

Overview

Surgery that changes the airway can alter voice quality by changing how sound resonates. The study investigated whether rhinoplasty affects the voice of people whose work depends on it. Thirty professional voice users completed the Voice Handicap Index and underwent acoustic voice analysis, including measurement of nasality using a nasometer and analysis of sustained vowels in a computerized speech lab.

Sections of note

• Cohort study of 30 professional voice users; the journal assigns level of evidence IV.
• Assessments were the Voice Handicap Index, nasalance measured with the Nasometer II, and computerized speech lab analysis of the vowels e and a, each sustained for 5 seconds.
• Mean Voice Handicap Index score was 8.5 plus or minus 1.98 before surgery and 7.36 plus or minus 1.71 after, with no significant difference, Z equals minus 0.53, P equals 0.59.
• There was a significant difference in Voice Handicap Index score between patients with and without preoperative obstruction, chi squared 11.06, P equals 0.004.
• Mean orality was 16.86 plus or minus 7.45 before and 15.22 plus or minus 7.37 after.
• Mean nasality was 59.42 plus or minus 6.04 before and 56.28 plus or minus 10.07 after.
• Neither orality nor nasality changed significantly, P equals 0.23 and P equals 0.36.

What it means for a patient

• Measured voice resonance did not change meaningfully after rhinoplasty in this group.
• Patients who had blocked breathing before surgery scored differently on the voice questionnaire than those who did not.
• Thirty patients is a small sample and the abstract does not state how long after surgery the follow up measurements were taken.
• The finding applies to the operations performed in this study, not to every type of nasal surgery.

Why this paper matters

Singers, actors and broadcasters routinely ask whether nasal surgery will change their voice, and there has been little measured evidence. This study applies both a patient questionnaire and acoustic instruments. Longer follow up and larger numbers would be needed to detect small persistent changes.

Terms

• Voice Handicap Index: a questionnaire measuring how much a voice problem affects daily life.
• Nasalance: the measured proportion of sound energy coming through the nose.
• Nasometer: an instrument measuring nasal versus oral sound output.
• Resonance: how the shape of the airway shapes the sound of the voice.
• Professional voice user: someone whose occupation depends on their voice.