Digital acoustic analysis of the first three formant frequencies in patients with a prosthesis after maxillectomy

Statement of problem. Prosthetic rehabilitation with an obturator can help to restore or improve the intelligibility of speech in patients after maxillectomy. The frequency of formants 1 and 2 as well as their ranges were initially reported in patients with maxillary defects in 2002, and the evaluation method that was used is now applied in clinical evaluation. However, the details of formant 3 are not known and warrant investigation because, according to speech science, formant 3 is related to the pharyngeal volume. Clarifying the formant frequency values of formant 3 in patients after maxillectomy would enable prosthodontists to refer to these data when planning treatment and when assessing the outcome of an obturator. Purpose. The purpose of this clinical study was to determine the acoustic characteristics of formant 3, together with those of formants 1 and 2, by using a digital acoustic analysis during maxillofacial prosthetic treatment. The utility of determining formant 3 in the evaluation of speech in patients after maxillectomy was also evaluated. Material and methods. Twenty-six male participants after a maxillectomy (mean age, 63 years; range, 20 to 93 years) were included, and the 5 Japanese vowels /a/, /e/, /i/, /o/, and /u/ produced with and without a definitive obturator prosthesis were recorded. The frequencies of the 3 formants were determined, and their ranges were calculated by using a speech analysis system (Computerized Speech Lab CSL 4400). The Wilcoxon signed rank test was used to compare the formants between the 2 use conditions (alpha=0.05). Results. Significant differences were found in the frequencies and ranges of all 3 formants between the use conditions. The ranges of all 3 formants produced with the prosthesis were significantly greater than those produced without it. Conclusions. Based on the findings, both the first 2 formants and the third formant were changed by wearing an obturator prosthesis. Because formant 3 is related to the volume of the pharynx, evaluation of this formant and its range can reflect the effectiveness of the prosthesis to seal the oronasal communication and help reduce hypernasality, suggesting the utility of formant 3 analysis in prosthodontic rehabilitation.