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Published on: June 20, 2018
The Effects of Preservation and Structural Rhinoplasty on Voice Parameters
Karahan Kara1, Mustafa Çağrı Derici1, Erdem Kaypak1
1Department of Otorhinolaryngology-Head and Neck Surgery, Adana City Training and Research Hospital, Adana, Türkiye.
Objectives:
To compare acoustic voice changes after preservation and structural rhinoplasty in women undergoing surgery for aesthetic indications.
Study Design:
Retrospective comparative study with repeated pre- and postoperative measurements.
Methods:
Forty women aged 20-30 years underwent preservation rhinoplasty (n = 20) or structural rhinoplasty with spreader graft reconstruction (n = 20). No preoperative nasal obstruction or laryngeal pathology was detected. Archived sustained /a/ recordings from one week preoperatively and 3 months postoperatively were analyzed in Praat for fundamental frequency (fo), local jitter, local shimmer, and harmonic-to-noise ratio (HNR). Smoothed cepstral peak prominence (CPPS) was added as an exploratory outcome. Within-group changes and between-group change scores were compared.
Results:
In the preservation group, fo remained stable (214.26 ± 8.97 vs 213.93 ± 8.90 Hz; P = 0.220), whereas jitter decreased from 0.327 ± 0.066% to 0.281 ± 0.065%, shimmer decreased from 2.05 ± 0.35% to 1.85 ± 0.36%, and HNR increased from 24.91 ± 1.48 to 26.19 ± 1.43 dB (all P < 0.001). In the structural group, fo also remained stable (220.29 ± 11.16 vs 220.29 ± 11.50 Hz; P = 0.985), while jitter decreased from 0.342 ± 0.086% to 0.304 ± 0.084%, shimmer decreased from 1.99 ± 0.37% to 1.82 ± 0.38%, and HNR increased from 24.66 ± 1.37 to 25.86 ± 1.49 dB (all P < 0.001). CPPS did not change significantly: preservation, 16.31 ± 1.20 vs 16.24 ± 1.41 dB (P = 0.543); structural, 17.65 ± 1.15 vs 17.54 ± 1.35 dB (P = 0.337). Preoperative CPPS was higher in the structural group (P < 0.001). The jitter reduction was greater with preservation (-0.046 ± 0.012% vs -0.038 ± 0.011%; P = 0.032). Changes in fo (P = 0.383), shimmer (P = 0.096), HNR (P = 0.457), and CPPS (P = 0.826) did not differ significantly between groups.
Conclusion:
Both techniques were associated with changes in perturbation and HNR, with no significant CPPS change. The small isolated jitter difference remains exploratory; the findings do not establish overall voice quality improvement or superiority of either technique.
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