Abstract
Background Puberphonia is the perseverance of high pitched voice after the pubertal age in males which causes a huge psychosocial impact. Voice therapy is one modality of management of Puberphonia. Aim The Objective of our study was to evaluate the efficacy of voice therapy in patients as the sole treatment to improve the pitch and quality of voice, the psychosocial impact and patient's satisfaction. Methods A retrospective study was carried out on 71 patients who were presented to ENT unit at the National hospital of Sri Lanka for fifteen years from 2002. Pre and post voice therapy subjective assessment was done by the speech therapist for pitch and quality and patient’s perceptual assessment using an analog scale (0-extremely poor to 10-normal voice) and a psychosocial impact assessment was also done. Results The time duration of voice therapy ranged from 1 to 10 months (average-3.6 months). Pitch and quality of the voice became normal in 78.9% and 35.2% of patients respectively. Pre-therapy perceptual score range(PSR) was 0 to 6 (mean-3.0). Post-therapy PSR was 5 to 10 (mean-7.7). 95.8% patients had improved psychosocial impact and patient satisfaction after voice therapy. Remaining opted for surgical management. Conclusion Voice therapy significantly improves the pitch, patient's satisfaction and psychosocial impact and can be used as an effective modality of treatment for Puberphonia.
Highlights
Puberphonia is the inability to eliminate the higher pitched voice of pre-pubescence and to substitute the lower pitched voice of post pubescence in the presence of a structurally normal larynx.(1) This is known as Mutational falsetto and Pubescent falsetto.(2) According to Banerjee the estimated incidence of puberphonia is 1: 90000 in india.(6)At puberty the total length of a boy’s vocal cord grow by as much as 60% and thyroid cartilage doubles in size
The aim of our study is to evaluate the efficacy of voice therapy in patients as the sole treatment to improve the pitch and quality of voice, the psychosocial impact and patient's satisfaction
A total of 71 patients were treated during the study period of 15 years. They were in the age group range of 14 to 24 years, diagnosed with Puberphonia by an ENT Surgeon on perceptual analyses and stroboscopic findings
Summary
Puberphonia is the inability to eliminate the higher pitched voice of pre-pubescence and to substitute the lower pitched voice of post pubescence in the presence of a structurally normal larynx.(1) This is known as Mutational falsetto and Pubescent falsetto.(2) According to Banerjee the estimated incidence of puberphonia is 1: 90000 in india.(6)At puberty the total length of a boy’s vocal cord grow by as much as 60% and thyroid cartilage doubles in size. In puberphonia the larynx tends to be held high in the neck, the cricoid cartilage is usually tilted backwards, the vocal folds are stretched and the acoustic analysis shows a speaking fundamental within the normal female range, intensity(3). Speech therapy is the mainstay of treatment(1). The aim of our study is to evaluate the efficacy of voice therapy in patients as the sole treatment to improve the pitch and quality of voice, the psychosocial impact and patient's satisfaction. Puberphonia is the perseverance of high pitched voice after the pubertal age in males which causes a huge psychosocial impact. Voice therapy is one modality of management of Puberphonia
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