Parsiyel ve Total Tonsillektomi Olan Hastaların Ses Bulgularının İncelenmesi
Özet
Adenotonsillectomy is one of the most frequently performed surgeries in the practice of ENT physicians. The most common indication for this surgery in children is recurrent tonsillitis and sleep apnea. One of the questions asked by families and individuals who have undergone surgery is the temporary or permanent voice change after surgery. One of the questions asked by families and individuals who have undergone surgery is whetherthere will be a temporary or permanent voice change after the surgery Although there are various methods and techniques for tonsillectomy, in this study we examined the voice findings of patients who had total tonsillectomy with the cold knife and bipolar method and partial tonsillectomy with the coblation technique. In this study, examination and surgery information of a total of 44 patients was obtained retrospectively from the Nucleus system in our hospital. 22 patients who underwent total tonsillectomy and 22 patients who underwent partial tonsillectomy were included in the study. Voice analysis tests before the surgery and at the 1st and 3rd months after the surgery were obtained from the hospital archives. Jitter, shimmer, NHR (Noise Harmonic Ratio), CPP (Cepstral Peak Prominence), CPP SD, L/H ratio, L/H RATIO SD AND formant frequencies F1, F2, F3 tests which were performed in the Speech Language Department, were examined along with the Ear Nose and Throat examination of the patients before the surgery and at the 1st and 3rd months after the surgery.
In our study, a significant statistical difference, both temporary and permanent, was observed in the total tonsillectomy technique, which is most commonly performed with the cold knife method, at formant frequencies. This suggests that there will be a change in the voice formant of the patients most commonly after surgery with this technique. Based on this information, in children who are indicated for tonsillectomy, the family should be given necessary information about changes of their voice before tonsillectomy. In another comparison, the decrease in the Pediatric Voice Handicap Index (PSHI) in both tonsillectomy methods shows that the change in the patients'
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postoperative voice perception improves their quality of life. In addition, there was a statistically significant decrease in the fundamental frequency (F0) of both methods in patients; This suggests that tonsillar tissue and tonsillectomy have an effect not only on voice resonance but also on the movement of the vocal folds, which are the primary sound producers.
The fact that there is no significant statistical difference in the data on the NHR and Cepstral parameters in both tonsillectomy methods shows that there may not be a significant change in the voice quality and noise ratio of the patients after this surgery.