Introduction
Speech and voice are essential parts of communication in daily life.
Nasal resonance plays an important role in speech quality. The
subjective perception of nasal sounds is defined as nasality, and it may
change with the patency of the nasal cavity. A structural alteration of
the nasal cavity, related to sinonasal disease or surgery, may cause
voice quality changes.1 According to the different
proportion of vocal amplification in the sinonasal cavities, abnormal
nasality can classify into hypernasality, hyponasality, and mixed
resonance.2 Hyponasal voice may be related to nasal
structural obstructive pathologies, such as rhinosinusitis, nasal
polyposis, or nasal septal deviation.3 On the other
hand, the voice of patients with cleft palate or velopharyngeal
incompetence usually presents as hypernasality. Traditionally, objective
examination of voice quality was subjectively evaluated by speech
pathologists using auditory perceptual methods. A nasometer is a
portable, noninvasive, and computer-based machine that provides an
objective evaluation of nasality called nasalance. The nasometer is
widely used to evaluate changes in nasality.4-6
Abnormal nasality is a common complaint; however, not much attention has
been paid to nasality in patients with sinonasal disease before. Chronic
rhinosinusitis (CRS) is an inflammatory condition of the sinonasal
mucosa, which includes the lining of nasal passage and paranasal sinus.
The swollen mucosa and congested nasal passage will decrease the
resonance of the nasal cavity and cause abnormal
nasality.7 Surgical interventions may change the
sinonasal structure and airway passage. Volumetric changes in the nasal
cavity will cause alterations in voice quality and
resonance8. Jiang et al. reported that an increase in
nasalance after functional endoscopic sinus surgery (FESS) correlated
with an increase in midnasal and postnasal volumes.9
Previous studies have presented nasalance change in CRS patients with
bilateral high disease burden after FESS.1,10,9,11However, nasality change in patients with only one side nasal airway
involvement has not been well investigated. Hence, the impact of
unilateral sinus surgery on nasality is not well known. Herein, we aimed
to investigate the prevalence of abnormal nasality in patients with
unilateral CRS. The subjective and objective nasality outcomes after
unilateral sinus surgery were measured and analyzed.