Perceptuell och akustisk bedo?mning av ro?stfunktion hos barn med tonsillhypertrofi
Effekter av kirurgi
Tonsillar hypertrophyTonsillectomyTonsillotomyVocal functionChildrenPerceptual analysisAcoustic analysisTonsillhypertrofiTonsillektomiTonsillotomiRo?stfunktionBarnAkustisk analysPerceptuell ro?stbedo?mning
In Sweden over 10.000 patients annually, mostly children, undergo tonsillar surgery. The most common surgical method is total removal of the tonsil, tonsillectomy (TE). During the last decade partial tonsil resection, tonsillotomy (TT), has been reintroduced and is associated with lower primary morbidity and less postoperative pain. The aim of the present study was to evaluate if and to what extent 4-5 year old children?s voice function are affected by tonsillar hypertrophy compared to controls and to study the effects of the two surgical techniques on vocal function. Sixty-seven children with tonsillar hypertrophy, where randomized either to TE or TT. A voice material consisting of words with only sonorants and three sustained vowels was recorded preoperatively and six months postoperatively. Eighty-two preschool children formed two control groups. The material was evaluated perceptually by three voice specialized speech and language pathologist and analyzed acoustically. Before surgery the children with tonsillar hypertrophy are rated to have higher prevalence of hoarseness, hyponasality and ?compressed/throaty voice? compared with the controls. The acoustic analysis show that the children with tonsillar hypertrophy have higher prevalence of perturbation (jitter (%), shimmer (%) and NHR) compared to the controls. Postoperatively there are no significant difference between the children with tonsillar hypertrophy and the control group perceptually. The acoustic analysis of the children with tonsillar hypertrophy still show more perturbation compared to the control group. The children operated with TE are rated to have less prevalence of roughness and hyponasality after surgery. The children in the TT-group have less prevalence of roughness, hyponasality and ?compressed/throaty voice?. The acoustic analysis show no significant difference between the two postoperative groups.