Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and tripleblinded peer-review principles. The journal is the official publication of

Background. Adenotonsillectomy is one of the most common pediatric surgical procedures. Postoperative voice changes are a very common concern among patient's parents. Therefore, the aim of this study is to analyze acoustic voice parameters after adenotonsillectomy, tonsillectomy, and adenoidectomy in pediatric patients in a tertiary referral academic center. Patients and Methods. All pediatric patients undergoing an adenotonsillectomy, tonsillectomy or adenoidectomy in a single center from 2002 to 2018 were included in the study. Change of fundamental frequency, jitter, shimmer, and harmonic-noise ratio at first, seventh and 30th postoperative day compared to preoperative values were the primary outcome parameters. Statistical analysis was performed using repeated measures analysis of variance model. Results. A total of 1258 patients were included in the study. The mean age of patients at the time of surgery was 8.3 years (range 3.0−18.0 years). Around 698 were male (55.5%) and 560 female (44.5%). The values of fundamental frequency increased significantly after the first and seventh postoperative day (P = 0.001 both) but normalized 1 month after surgery (P = 0.962). At the first postoperative month, values of jitter and shimmer decreased significantly (P = 0.005 and P = 0.002, respectively). Measurements of harmonic-noise ratio revealed a significant increase 30 days after surgery (P = 0.004). Conclusion. Statistically significant differences in objective voice parameters within the first postoperative month after tonsillectomy, adenoidectomy, and adenotonsillectomy were observed. The fundamental frequency returned to normal 1 month after surgery. These findings can contribute in soothing the concerns of parents regarding postoperative voice changes.

Objectives: The present study aimed to determine the voice outcomes before and after the administration of voice therapy in patients who suffered an injury to the recurrent laryngeal nerve after undergoing thyroidectomy. Methods:The sample consisted of 26 patients (2 males and 24 females) aged between 18 and 80 years (m=55±12) who experienced injury to the recurrent laryngeal nerve following thyroidectomy that was used to treat a thyroid gland disease. Subjective and objective parameters of the voice of the patients as well as its aerodynamic aspects were assessed upon the completion of the surgical procedure and before and after the implementation of voice therapy. Objective voice analysis was performed with the help of computer software viz. "Speech Training for Windows, Version 4.00 -Dr. Speech "and" EZ Voice Plus (TM) v. 2.0;" while GRBAS scale was used for subjective voice assessment. The subjects were followed for two years. The data so collected during this period was analyzed by implementing descriptive statistical parameters, Chi-square test, t-test and Wilcoxon test. Results:Patients with an injury to the recurrent laryngeal nerve were found to have voice alterations in all vocal parameters of subjective voice assessment conducted using the GRBAS Scale. These alterations ranged from moderate to severe degree, which provided a high degree of roughness in the voice. Objective voice assessment parameter analysis showed a decrease in voice pitch, increase in shimmer, decrease in noise-to-harmonics ratio, decrease in maximum phonation time and a decrease in voiceless percentage. Overall, it was observed that there were significant differences in all parameters of subjective and objective voice assessment, before and after vocal therapy, except for variables regarding the noise-to-harmonics ratio and aerodynamic variable of the S/Z ratio, although, the results on these vocal parameters were better after voice therapy.