Effect of Adenotonsillar Hypertrophy on the Voice in Children

Objective: Changes in vocal patterns after adenotonsillectomy are questionable. Few studies have assessed acoustic voice changes pre and post adenotonsillectomy. The objective of this study was to evaluate the effect of adenotonsillectomy on the voice of children with adenotosillar Hypertrophy .

Study design: prospective study

Sitting: - tertiary care hospital (Minia university hospital)


Methods: The study included fifty children ranging in age between 4 and 12 years, with adenotonsillar hypertrophy, indicated for adenotonsillectomy. Auditory perceptual assessment of speech included nasality, degree of hyponasality, degree of open nasality, and degree of dysphonia. Acoustic analysis was carried out before and after one month and three months of surgery, using multidimensional voice program software (MVDP). The vowels were analyzed as to their acoustic parameters: fundamental frequency (Hz), jitter (%), shimmer (dB) and noise-harmony ratio (NHR; dB).

Results: Our results reveal that there are statistical significance in FO, Jitters, Shimmer between preoperative and postoperative results and improvement continues even after three months postoperatively there’s no statistical significance regarding HNR preoperative and post operative. There is weak statistical significant in correlation between HNR and APA of Voice and APA of speech after one month postoperatively as (P=0.047)

Conclusion: Hypertrophied tonsil and Adenoid can lead to Hyponasal speech and/ or dysphonia this can be improved after their removal, so voice and speech changes that results from enlarged tonsil and Adenoid can be considered as indication of adenotosillectomy.