Effect of weight loss on voice after bariatric surgery

To investigate the effect of weight loss on voice.

Prospective study.

A total of 15 subjects undergoing bariatric surgery were investigated. Six subjects were lost to follow-up, and nine subjects were evaluated preoperatively and 3-6 months postoperatively. The evaluation included a questionnaire on voice quality filled by the patient, laryngeal examination, perceptual evaluation, and acoustic analysis. The questionnaire consisted of four questions: change in vocal pitch, change in vocal loudness, increase or decrease in phonatory effort, and the presence or absence of vocal fatigue. For the perceptual evaluation, a simplified version of the Grade, Roughness, Breathiness, Asthenia, Strain scale classification was used. These parameters were rated using a score ranging from zero to three where zero stands for none and three for severe. For the acoustic analysis, the following variables were measured: fundamental frequency, habitual pitch, jitter, shimmer, noise-to-harmonics ratio, voice turbulence index, and maximum phonation time.

The mean age was 35.56 ± 9.93 years. The mean weight preoperatively and postoperatively was 112.17 and 83.61 kg, respectively. The body mass index dropped by eight points from 38.06 to 30.83. Only three of the nine patients have reported change in voice quality. The latter was described as an increase in vocal pitch in the three cases, reduced loudness and increased phonatory effort in two, and the presence of vocal fatigue in one. There was no significant difference in the mean score of any of the perceptual parameters in patients preoperatively versus postoperatively. There was also no significant difference in any of the acoustic parameters or in the laryngeal findings before and after surgery.

One-third of the patients with weight loss reported change in voice quality that was not documented acoustically. The laryngeal examination is nonrevealing.