KISEP Rhinology Korean J Otolaryngol 1999;42:871-5 부비동내시경수술후비음도변화 동헌종 김선일 권중근 윤영선 강수미 추광철 Effects of Endoscopic Sinus Surgery on Nasality Hun-Jong Dhong, MD, Sun-Il Kim, MD, Joong-Keun Kwon, MD, Young-Sun Yun, MA, Su-Mi Kang and Kwang-Chol Chu, MD Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea ABSTRACT Background and ObjectivesWhen the impairment of nasal airway patency in patients with chronic sinusitis such as mucosal edema or nasal polyps is resolved after functional endoscopic sinus surgery FESS, it is expected that patients no longer complain of hyponasal voice. However, patients who have undergone FESS sometimes complain of more hyponasal voice, or thick voice. The purpose of this study was to examine the effect of FESS on voice in terms of nasality. Materials and MethodsThirty-three patients who underwent FESS and thirty normal adults who had no sinus or nasal pathology were selected for this study. We performed nasalance test for patients group before and 3 months after the operation and for the control group without any medication. ResultsPatients preoperative mean nasalance were not low compared with that of control group in all sentences. It was different from perceptual hyponasality they had complained. Postoperative mean nasalance in patients showed statistically significant increase. Higher change ratio of nasalance was noted in Mamma passage than the other passages. ConclusionThere was significant increase in nasalance scores after FESS. Thus, we must consider the possibility of voice changes postoperatively in professional voice users. Korean J Otolaryngol 1999; 42:871-5 KEY WORDSEndoscopic sinus surgery Nasalance Voice change. 871
872 Table 1. Standard Korean nasal sentences used in nasometric test proposed by Hong, et al Rabbit passage NCR*0% kpukiwa t h okiwj talliki ijakicjo MNS 17.4% Baby passage NCR11.7% MNS32.6% Mamma passage NCR34.7% MNS54.7% t h ok ika cakihako taklliki sihaphacako k h wke solic h ica kpukika kwlcako htjo akika mmap h ume camtwl itwlk ajo uliaki jep wnaki skwn skwn camcajo mmanwn hansan lemoncmwl mantwl imola nunala nanu cupnita /ulimma cown mma/ * NCRnasal consonant ratio MNSmean nasalance score Table 2. Mean nasalance score of the Rabbit, Baby, Mamma passage in pre- and postoperative and control group. Values are expressed as meanstandard deviation in percent % Preoperative N33 Patient group Postoperative 3 months N33 Control group N30 Rabbit passage 25.0611.84 35.968.64* 19.779.43 Baby passage 42.44 9.50 52.247.79* 37.579.72 Mamma passage 62.44 8.52 70.616.34* 55.177.53 *Significant change was found in the nasalance of all passages after operation p0.05 Korean J Otolaryngol 1999;42:871-5
Table 3. Mean nasalance score of the Rabbit, Baby, Mamma passage in pre- and postoperative according to their degree of nasal polyp. Values are expressed as meanstandard deviation in percent % Rabbit passage Baby passage Mamma passage Group 0 N12 Preoperative 24.1510.91 44.05 8.87 64.52 7.34 Postoperative 37.04 8.37* 52.06 7.7* 71.26 5.95* Group 1 N 6 Preoperative 29.0613.37 43.92 8.64 64.58 3.37 Postoperative 34.47 9.17* 51.11 9.35* 69.26 8.34* Group 2 N12 Preoperative 23.9913.71 40.9711.73 60.0811.56 Postoperative 34.12 7.19* 51.87 7.04* 69.99 6.55* Group 3 N 3 Preoperative 25.04 6.80 38.94 3.94 59.27 3.8 Postoperative 41.9714.99* 56.7510.85* 73.25 4.22* Group 0 indicate no grossly visible polyp, group 1 patial obstruction of middle meatus, group 2 total obstruction of middle meatus, and group 3 extension into nasal vestibule * Significant change was found in the nasalance of all passages after operation regardless of group p0.05 Inter-group differences were not statistically significant in all passages (p0.05) Table 4. Mean change ratio of the Rabbit, Baby, Mamma passage according to the extent of endoscopic sinus surgery. Values are expressed as meanstandard deviation in percent % Rabbit passage Baby passage Mamma passage Pansinus* N16 74.9799.90 29.2338.24 17.7131.65 Others N17 74.5495.66 27.2325.99 13.3511.83 873
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