The Effects of Anterior Palatoplasty and Functional Expansion Sphincter Pharyngoplasty on Voice Quality in Patients with Obstructive Sleep Apnea

We aimed to examine the effects of anterior palatoplasty (AP) and functional expansion sphincter pharyngoplasty (FESP) on voice quality in patients with OSAS and to compare them with each other.

The study included 380 patients who came to the Otorhinolaryngology Clinic of our hospital with symptoms of snoring and sleep apnea between April 2020 and April 2022 and were referred to the sleep laboratory for polysomnography (PSG).Forty patients who met the study criteria and underwent AP and 26 patients who underwent FESP were included in the study. All surgeries were performed under general anesthesia by the same otolaryngologist within 1 month at the latest after sleep endoscopy. Acoustic voice analysis was performed using the Praat voice analysis program preoperatively and postoperatively at 6 months. F0, jitter, shimmer, and NHR (noise-to-harmonic ratio) were compared between the groups pre and postoperatively.

There were 20 females and 20 males in the AP group, 12 females and 14 males in the FESP group, There was no statistically significant difference in sex distribution between the groups (P = 0.952). The difference between the preop and postop F0, jitter, shimmer, and NHR in both the AP and FESP groups was statistically significant (P < 0.01). After AP and FESP surgeries, F0 values ​​increased, jitter, shimmer and NHR values ​​decreased (P < 0.01).F0, jitter, shimmer, and NHR changes were the greatest in the FESP group.(P < 0.01).

Positive changes in F0, jitter, shimmer, and NHR were greatest in the FESP group significantly. FESP surgery affects voice quality more than AP surgery in patients with OSAS.