Abstract
Objective: To assess effects of type 3 thyroplasty on outcomes of voice quality in puberphonia.
 Methods:
 Design: Prospective Cohort
 Setting: Tertiary Referral Hospital
 Participants: 6 patients with puberphonia who failed voice therapy, aged 16-25 years, who consulted at the ENT Outpatient department between September 2010 and September 2012, underwent type 3 thyroplasty.
 Pre-operative and 6-month post-operative voice analysis by voice recordings, Voice Handicap Index (VHI), GRBAS score and real time acoustic analysis (perturbation) using Dr Speech software (University version 4.0, Voice Tech Corporation, USA [Tiger Electronics]) using habitual fundamental frequency (F0), jitter % and shimmer % as parameters, were performed.
 
 Results: Mean pre-operative VHI and GRBAS scores were 53 and 75.67 respectively whereas post-operative scores were 29 and 25.00 respectively. (P-value for VHI was 0.004 and that of GRBAS was 0.00). On acoustic analysis, mean pre-operative habitual fundamental frequency (F0), jitter % and shimmer % was 245.82 Hz, 0.21 and 2.34 respectively whereas post-operative mean was 140.78 Hz (P = 0.00), 0.19 (P = 0.04) and 1.52 (P = 0.00) respectively.
 
 Conclusion: The mainstay of treatment of puberphonia is voice therapy. Thyroplasty provides a suitable management option in those cases who fail to respond by voice therapy.
 
 Keywords: puberphonia, thyroplasty, laryngeal framework surgery, voice analysis
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