Orthognathic surgery: Effects on voice and wind instrument performance

Abstract

Orthognathic surgery consists primarily of surgery that is performed on the maxilla and mandible to correct dento-maxillofacial asymmetries and skeletal angle deformities. Maxillary surgery consists primarily of Le Fort 1 osteotomy and segmental osteotomy, whereas mandibular surgery incorporates bilateral sagittal split osteotomy, segmental osteotomy, and osseus genioplasty. Complications of orthognathic surgery are numerous and they include dysphonia. The change in voice quality is ascribed to surgery-induced anatomic changes in the oral cavity, nasal cavity, and pharynx, leading to variations in the position and dispersion of vocal tract formants. Though these acoustic changes are often masked by compensatory phonatory and articulatory behavior, wind instrument players and voice professionals remain at a risk. Proper awareness of surgery-induced vocal tract changes and their potential impact on music performance is paramount in patients' counselling preoperatively. This information is also important in the management strategy and rehabilitation of patients following surgery.