الفهرس 
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Abstract
All bodily systems are affected by obesity to varying degrees. The respiratory system, vocal folds, and vocal tract are all impacted upon in this process.
Voice production might be hampered by the aberrant accumulation of adipose tissue in the upper airway. Reduced lung function, brought on by an increase in adipose tissue around the ribs and belly, influences voice performance because it lowers thoracic compliance and respiratory muscle strength in obese people. Therefore, it changes the physiology of the respiratory structures of the phonatory components, making it hard for these people to produce their voices (SOUZA et al., 2015).
When comparing the sizes of the upper airway clearances, Bosso et al., 2021 found a negative correlation between body mass index and belly fat. The authors found that 25.9% of obese women had hoarseness, 18.5% experienced pharyngeal secretion, 18.5% experienced speech fatigue, and 11.2% experienced voice loss.
Certain anatomical and functional changes brought on by obesity cause a decline in voice quality and a shorter maximum phonation duration in those who are fat. Obese individuals see a drastic decrease in ERV when their body mass index (BMI) rises (Munjal et al., 2021)
According to a 2016 study by Wolfe et al., bariatric surgery has been proven to result in more weight reduction than non-surgical treatment and, more crucially, to sustain that loss over time. So, bariatric surgery is the only effective treatment for severe obesity right now.
To better understand how voice is affected by bariatric surgery in morbidly obese individuals, we conducted this research.
Fifty patients with severe obesity were selected at random and observed 3 and 6 months after bariatric surgery in our research. The following survey study collected this information from each patient before surgery, three months after surgery, and six months after surgery: Patient Interview and history taking, Auditory Perceptual Assessment (APA), general examination (BMI and NC), Voice Handicapped Index, laryngoscopy, acoustic analysis.
The findings of this research demonstrated that: • There were significant variations in body mass index (BMI) between pre- and post-operative periods I and II.
• There were large variations in neck circumference between before surgery, after surgery I, and after surgery II, and these differences were statistically significant.
• There were large, statistically significant variations in reflux levels before and after surgery.
Significant variations in total VHI between preoperative and postoperative II were found.
• Congestion and irregularity in the interarytenoid area were significantly different between pre- and post-operative I.
Significant changes in congestion severity were seen between pre- and post-operative II.
• Congestion and irregularity in the interarytenoid area differed significantly between pre- and post-operative II, and these variations were highly statistically significant.
• There were substantial variations in jitter levels between the pre- and post-op periods.
• There were statistically significant changes in MPT between preoperative I and postoperative I.
Significant changes in jitter levels were seen between pre- and post-operative II.
• There were statistically significant variations in MPT between the preoperative and postoperative II periods.
The level of shimmer was significantly different between pre- and post-operative II.
• There were substantial changes in HNR between II before and after surgery.
• Pitch was found to vary significantly between pre- and post-operative II.
• There were statistically significant variations in MPT between postoperative I and postoperative II.
In terms of systemic disorders, there were striking contrasts between pre- and post-operative I and II.
Conclusion & Recommendation
Obesity is clearly associatev associated with physiological changes in voice production and quality. Patients who are overweight have a harder time keeping their voice steady for lengthy periods of time.
A significant and slow decline in anthropometric measures was seen after bariatric surgery. The voice’s pitch increased, its stability increased, and its maximum phonation duration increased, making it less raspy and more pleasant to listen to.
The findings of this research support the goal of achieving and maintaining a healthy body weight.