Voice and Speech Changes After Tonsillectomy

Does tonsillectomy cause voice changes?

Voice and Speech Changes After Tonsillectomy

After tonsillectomy, patients may have changes in voice and speech.

Patients with large tonsils have a significant increase in airway after surgery. However, there may also be edema and pain in the soft palate and small tongue. Consequently, patients may have difficulty in speaking or changes in voice. Usually after a few weeks this may improve. However, there is also an increase in the distance behind the palate (velopharyngeal space) in children with tonsil and nasal flesh. Therefore, the amount of air to the nose increases when talking (velopharyngeal insufficiency / hypernazality), as well as breathing through the nose, the sinuses can contribute to the shaping of the sound and there may be differences in tone. Within a few weeks after surgery, many troubles will disappear. If the velopharyngeal insufficiency persists, followed by a speech therapist, and re-narrowing of this area can be performed.

How can voice and speech be adversely affected during tonsillectomy

Temporary and permanent voice changes may occur after tonsillectomy; however, as the vocal cords are not affected during tonsil surgeries, no loss of voice or decrease in speech skills is expected, damaging the vocal cords is very rare (only due to tube placement during anesthesia).

It is not expected to change the phonation with vocal cords after tonsil surgery. Rarely, depending on the pressure of the intubation tube used during general anesthesia or due to postoperative coughing of the patient, temporary vocal cord edema and hoarseness may occur.

Short-term and long-term effects of tonsillectomy on voice and speech / Image source: How to Know if It's God's Voice

During the tonsillectomy operation, if the nerves passing by the tonsil and causing the movements of the soft palate muscles are damaged, or if the recovery in the soft palate after the operation has resulted in excessive tension, a change in voice and speech may occur. It is necessary to try to understand this during the examination and also to see if there is any nasal and nasal escaping during liquid food intake.

During tonsillectomy, a permanent change in the airway, ie enlargement occurs. In other words, the airway cross-sectional area at the beginning of the upper airways increases. During the procedure, temporal edema and decreased movement of the soft palate and small tongue adjacent to the tonsils may also occur and temporary and permanent voice changes may occur after tonsillectomy.

In the first weeks after tonsil operations, due to transient tissue changes such as soft palate and small tongue edema, decreased motion due to bee in the tissues around the tonsil, the shaping and resonance of the sound after being formed in the vocal cords may be affected. Temporary voice changes usually disappear within 2-3 weeks. However, due to the bilateral removal of the tonsillary tissue, changes in volume may occur as a result of permanent upper airway diameter change.

When tonsillectomy is performed together with adenoidectomy surgery in children, additional changes in sound resonance can be expected since the amount of air and sound waves passing through the nasal cavity will increase.

Abroad, especially for operas artists, the sound changes slightly or the throat region developed by the artists can make the sound making techniques inadequate or vice versa.

In other words, patients with large tonsils are more likely to have permanent voice changes after surgery. Tonsils and nasal flesh surgery will also be performed in children with tonsil growth and nasal flesh growth in patients with advanced levels of nasal fever, postoperative, more likely to occur voice changes. There are comments about changes in the horizontal diameter and changes in the vertical diameter of the pharyngeal region after tonsillectomy, but the subject is not clear and it is generally thought that there will not be much voice changes due to tonsillectomy. In spite of short-term voice changes, especially in the long term (tonsils after the 3rd month after surgery) will not cause any changes in the voice of scientific articles have been written. There are also scientific articles advocating that tonsillectomy can lead to an increase in sound production and louder sound.
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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