Impact of 3-dimensional anatomical changes secondary to orthognathic surgery on voice resonance and articulatory...

An evaluation was made of the impact of orthognathic surgery (OS) on speech, addressing in particular the effects of skeletal and airway changes on voice resonance characteristics and articulatory function. A prospective study was carried out involving 29 consecutive patientssubjected to OS. Preoperative, and short and long-term postoperative evaluations were made of anatomical changes (skeletal and airway measurements), speech evolution (assessed objectively by acoustic analysis: fundamental frequency, local jitter, local shimmer of each vowel, and formants F1 and F2 of vowel /a/), and articulatory function (use of compensatory musculature, point of articulation, and speech intelligibility). These were also assessed subjectively by means of a visual analogue scale. Articulatory function after OS showed immediate improvement and had further progressed at one year of follow up. This improvement significantly correlated with the anatomical changes, and was also notably perceived by the patient. On the other hand, although a slight modification in vocal resonance was reported and seen to correlate with anatomical changes of the tongue, hyoid bone, and airway, it was not subjectively perceived by the patients. In conclusion, the results demonstrated that OS had beneficial effects on articulatory function and imperceptible subjective changes in a patient's voice. Patients subjected to OS, apart from benefitting from improved articulatory function, should not be afraid that they will not recognise their voice after treatment.