Voice Outcomes after Expansion Sphincter Pharyngoplasty in Patients with Obstructive Sleep Apnea Syndrome

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dc.contributor.authorTüre, Nurullah
dc.contributor.authorSubaşi, Buğra
dc.contributor.authorÇevi̇k, Didem
dc.contributor.authorAkdağ, Gönül
dc.contributor.authorVarol, Mehmet
dc.date.accessioned2026-07-01T11:36:27Z
dc.date.available2026-07-01T11:36:27Z
dc.date.issued2026
dc.departmentDüzce Üniversitesi
dc.description.abstractObjective: The aim of this study was to evaluate the temporal changes in perceptual, acoustic, and cepstral voice parameters following expansion sphincter pharyngoplasty (ESP) in patients with moderate-severe obstructive sleep apnea syndrome (OSAS). Method: In this prospective, nonrandomized clinical study, ESP was performed on 27 adult patients with moderate-severe OSAS. Voice assessments were conducted preoperatively, at 1 week postoperatively, and at 3 months postoperatively using the Turkish Voice Handicap Index-10, Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale, acoustic parameters (fundamental frequency, jitter %, shimmer %, and noise-to-harmonic ratio [NHR]), formant frequencies (F1-F4), and cepstral measurements (cepstral peak prominence [CPP], smoothed cepstral peak prominence [CPPS]) during sustained /a/ phonation and connected speech. Statistical analyses were performed using the Friedman test and Analysis of Variance (ANOVA). Results: Regarding perceptual evaluation, although Friedman tests indicated statistical variance in Grade (P = 0.016) and Roughness (P = 0.005), conservative post hoc analyses revealed no statistically significant pairwise differences, suggesting perceptual stability. Objective acoustic analysis demonstrated a significant increase in Shimmer (P = 0.020) and a decrease in NHR (P = 0.011) by the third postoperative month. Cepstral analysis revealed a significant decrease in sustained /a/ CPP (P = 0.007) and CPPS (P = 0.010), reflecting reduced signal periodicity, while connected speech CPP showed significant variance (P = 0.020). Conclusion: ESP characterizes as a functionally safe and resonance-sparing intervention. Although the procedure induces subclinical acoustic perturbations manifesting as reduced signal periodicity, it maintains perceptual stability and does not compromise functional communication. Preoperative counseling regarding these subtle acoustic changes is recommended, particularly for professional voice users. © 2026 The Voice Foundation. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
dc.identifier.doi10.1016/j.jvoice.2026.01.015
dc.identifier.issn0892-1997
dc.identifier.pmid41580324
dc.identifier.scopus2-s2.0-105029499395
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1016/j.jvoice.2026.01.015
dc.identifier.urihttps://hdl.handle.net/20.500.12684/23033
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Inc.
dc.relation.ispartofJournal of Voice
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_Scopus_20260623
dc.subjectCepstral
dc.subjectExpansion sphincter pharyngoplasty
dc.subjectFormant
dc.subjectJitter
dc.subjectShimmer
dc.subjectVoice analysis
dc.titleVoice Outcomes after Expansion Sphincter Pharyngoplasty in Patients with Obstructive Sleep Apnea Syndrome
dc.typeArticle

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