Hypernasality after using the endoscopic endonasal transsphenoidal approach for skull base tumors

Area of Science:

• Otolaryngology
• Neurosurgery
• Speech Pathology

Background:

• Endoscopic endonasal transsphenoidal approaches (EETSA) are increasingly used for pituitary and skull base surgeries.
• Voice changes are a recognized sinonasal complication following EETSA.
• The impact of patient age on postoperative voice alterations requires further investigation.

Purpose of the Study:

• To compare preoperative and postoperative voice changes in patients undergoing EETSA.
• To analyze the influence of age on the incidence and severity of voice alterations after EETSA.

Main Methods:

• Retrospective review of 170 patients who underwent binostril four-hand EETSA.
• Patients categorized into three age groups: ≤30, 31-60, and ≥60 years.
• Preoperative and 6-month postoperative voice evaluations included acoustic analysis, nasometry (nasalance scores), and Voice Handicap Index (VHI).

Main Results:

• All EETSA patients showed significant increases in nasalance, jitter, shimmer, and VHI scores postoperatively.
• The ≤30 age group exhibited increased nasalance for nasal sentences.
• The 31-60 age group showed increased nasalance for oronasal and nasal passages.
• The >60 age group demonstrated increased nasalance for oronasal and nasal passages, along with higher jitter and shimmer scores.

Conclusions:

• Endoscopic endonasal transsphenoidal approaches are associated with voice changes.
• Older age may predispose patients to hypernasality and vocal roughness after EETSA.
• Informing patients about potential voice changes is crucial before EETSA procedures.