{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:41:16Z","timestamp":1781646076065,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T00:00:00Z","timestamp":1436227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The increasing number of endoscopic endonasal transsphenoidal approaches (EETSA) has resulted in several sinonasal complications, including voice changes. Here, we compared preoperative and postoperative voice changes according to age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the medical records. Patients were divided into the following three groups according to age:\u2009\u2264\u200930 years, 31 to 60 years, and\u2009\u2265\u200960 years. Patients underwent preoperative voice evaluation using acoustic analysis, a nasometer, and the voice handicap index (VHI). A nasometer was used to measure the nasalance scores. The subjects read or repeated three speech stimuli. For each stimulus, mean nasalance scores were obtained and age dependence was analyzed. Repeat testing was performed 6 months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and seventy patients who underwent binostril four\u2010hand EETSA with a bilateral modified rescue flap were included in this study. Mean nasalance scores for the oral passage, oronasal passage, and nasal passage\u2014as well as mean jitter scores, shimmer scores, and VHI\u2014were significantly increased in all of the EETSA patients (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 for all). Mean nasalance scores for the nasal sentences were significantly increased in the\u2009\u2264\u200930 age group (all, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Scores for the oronasal passage and nasal passage were significantly increased in the 31 to 60 age group (all, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Scores for the oronasal passage, nasal passage, jitter, and shimmer were significantly increased in the\u2009&gt;\u200960 age group (all, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endoscopic endonasal transsphenoidal approaches might contribute to voice changes. In addition, older age might produce hypernasality and roughness after EETSA. Patients who plan to undergo EETSA should be informed that their voice may change after the operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 126:329\u2013333, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25450","type":"journal-article","created":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T18:25:03Z","timestamp":1436293503000},"page":"329-333","source":"Crossref","is-referenced-by-count":8,"title":["Hypernasality after using the endoscopic endonasal transsphenoidal approach for skull base tumors"],"prefix":"10.1002","volume":"126","author":[{"given":"Boo\u2010Young","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji\u2010Hyeon","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"},{"name":"Minimal Access and Robotic Surgery Center Seoul St. Mary's Hospital"},{"name":"Department of Biomedical Science The Catholic University of Korea, College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Kil","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sin\u2010Soo","family":"Jeun","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"},{"name":"Minimal Access and Robotic Surgery Center Seoul St. Mary's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Whan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyung","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon\u2010il","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Joo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi\u2010Ran","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon\u2010Shin","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-008-0135-y"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/02688690701395447"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21483"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20949"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21069"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e318282a535"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2226-x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24674"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24098"},{"key":"e_1_2_6_11_1","first-page":"88","volume-title":"Speaker Classification I Lecture Notes in Computer Science: Volume 4343","author":"Susanne Schotz. 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