Effect of Age and Gender on Nasalance Across the Lifespan: A Systematic Review

Abstract

ObjectiveThe Nasometer^® is a widely used clinical and research tool with diagnosis and outcome measurement utility. The objective of this study was to systematically examine the effect of age and gender on nasalance across the lifespan.DesignA systematic review was performed according to the Preferred Reporting Items for Systematic Reviews (PRISMA 2020).SettingUniversity.ParticipantsChildren, adolescents, adults, and older adults.InterventionsCovidence Better Systematic Review Management; Scottish Intercollegiate Guidelines Network Methodology (SIGN) Checklist 3 for risk of bias; Levels of evidence, Oxford Centre for Evidence-Based Medicine Levels of Evidence hierarchy; and effect size calculations using G*Power 3.Main outcome measuresNasalance (%) from the Nasometer™.Results50 studies (from N = 1884) were included in the review. All were Level 3 (non-randomized controlled cohort) observational-analytic type studies. Only 10 (20%) of studies met a High Quality (low risk of bias) rating. Effect sizes were moderate for adults versus children (d = 0.717) and adults versus adolescents (d = 0.521) for oral text/passage. Gender differences were clinically significant for adolescent males and females with a moderate effect size (d = 0.545) for oronasal text/passage.ConclusionThe systematic review provides objective and defined evidence as to the effects of age and gender on nasalance. Separate normative databases are implicated for specific age subgroups across the lifespan and for gender, particularly in adolescence. Review findings are applicable to other clinical groups where acquisition and/or progression occurs in adulthood/older adulthood.

Keywords: nasalance; systematic review; velopharyngeal dysfunction.