• Atul Goel, Apurva Prasad, Abhidha Shah, Sandeep Gore, and Pralhad Dharurkar.
• Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India; Department of Neurosurgery, Lilavati Hospital and Research Centre, Bandra (E), Mumbai, India. Electronic address: atulgoel62@hotmail.com.
• World Neurosurg. 2019 Jan 1; 121: e296-e301.

ObjectiveVoice alteration as a presenting symptom in cases with Chiari formation is analyzed, as well as outcome after atlantoaxial fixation.MethodsDuring the period January 2016 to June 2017, 25 cases of Chiari formation presented with associated or a major presenting symptom of voice or speech quality alteration related to inadequate breathing efforts. All patients underwent atlantoaxial fixation. No foramen magnum decompression was done.ResultsIn all patients, the voice quality and volume and breathing disturbances improved in the immediate postoperative period after recovering from anesthesia. During the period of follow-up that ranged from 12 to 25 months, all patients continued to improve in their speech function.ConclusionsSuch critical symptoms of voice disturbance and inadequate breathing and the possibility of rapid postoperative recovery have not been recorded earlier in the literature.Copyright © 2018 Elsevier Inc. All rights reserved.

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