Karaoğullarından Ayşe, Erkan Sanem Okşan
ENT Specialist in Adana City Training and Research Hospital ENT Department, Yüreğir, Adana, Turkey.
ENT Specialist in Adana City Training and Research Hospital ENT Department, Yüreğir, Adana, Turkey.
J Voice. 2025 Jul;39(4):1141.e13-1141.e19. doi: 10.1016/j.jvoice.2023.01.033. Epub 2023 Mar 24.
This study aimed to examine the effects of barbed pharyngoplasty (BP) on voice quality in patients with Obstructive sleep apnea syndrome (OSAS) and to compare them with the anterior palatoplasty (AP) and expansion sphincter pharyngoplasty (ESP) surgeries.
The study included 329 patients who came to the Otorhinolaryngology Clinic of our hospital with symptoms of snoring and sleep apnea between January 2020 and 2022 and were referred to the sleep laboratory for polysomnography (PSG). AP surgery was recommended for those with retropalatal stenosis in the anteroposterior direction, and ESP surgery for those with lateral stenosis. BP was recommended for those with both anteroposterior and lateral retropalatal stenosis. 60 patients who met the study criteria 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 groups pre and postoperatively.
F0 %, jitter %, shimmer %, and NHR % changes were highest in BP. Jitter, shimmer, and NHR decreased significantly in the BP group, whereas F0 increased significantly. Although the mean F0 increased in both AP and ESP groups, the greatest change was in the AP group following BP groups. Although the average jitter, shimmer, and NHR decreased in both groups, the greatest change was in the ESP group following BP groups.
In patients with OSAS, BP surgery changed F0, jitter, shimmer and NHR more than AP and ESP surgeries, and effected the voice quality more positively.
本研究旨在探讨倒刺咽成形术（BP）对阻塞性睡眠呼吸暂停综合征（OSAS）患者嗓音质量的影响，并将其与前腭成形术（AP）和扩约肌咽成形术（ESP）进行比较。
本研究纳入了2020年1月至2022年间因打鼾和睡眠呼吸暂停症状前来我院耳鼻喉科门诊就诊，并被转诊至睡眠实验室进行多导睡眠图（PSG）检查的329例患者。对于前后径方向存在腭后狭窄的患者，建议行AP手术；对于存在侧方狭窄的患者，建议行ESP手术。对于同时存在前后径和侧方腭后狭窄的患者，建议行BP手术。60例符合研究标准的患者被纳入研究。所有手术均在全身麻醉下由同一位耳鼻喉科医生在睡眠内镜检查后最晚1个月内完成。术前及术后6个月使用Praat嗓音分析程序进行声学嗓音分析。比较术前和术后各组之间的F0、抖动、闪烁和NHR（噪声与谐波比）。
BP组的F0%、抖动%、闪烁%和NHR%变化最大。BP组的抖动、闪烁和NHR显著降低，而F0显著升高。虽然AP组和ESP组的平均F0均升高，但变化最大的是仅次于BP组的AP组。虽然两组的平均抖动、闪烁和NHR均降低，但变化最大的是仅次于BP组的ESP组。
在OSAS患者中，BP手术对F0、抖动、闪烁和NHR的改变大于AP手术和ESP手术，且对嗓音质量的影响更为积极。
