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Abstract:
Puberphonia is persistence of adolescent voice after puberty in the absence of organic cause. This common condition is seen in males. These patients have a high pitched voice. This article at-tempts to review published literature on this topic with specific focus on conservative management. This condition is also considered to be a psycho-genic voice disorder. Conservative management has met with excellent success. Conservative man-agement modalities for this condition ranges from voice therapy to laryngeal manipulation
Introduction:
The persistence of adolescent voice even after pu-berty in the absence of organic cause is known as Puberphonia1. This condition is commonly seen in males. This is uncommon in females because laryngeal growth spurt occurs commonly only in males. According to Banerjee the incidence of Puberphonia in India is about 1 in 900,000 pop-ulation 2. In females this condition is known as “Juvenile Resonance Disorder” or a “Little Girl’s Voice”. This condition is characterised by vocal instability with extensive frequency swing.
Pathophysiology:
In infants the laryngotracheal complex lies at a higher level. It gradually descends. During puberty in males this descent is rapid, the larynx becoming larger and unstable and on top of it the brain is more accustomed to infant voice.
The boy may hence continue to use a high pitched voice or it may break into higher and lower pitch-es 3.
Etiology: include
1. Emotional stress
2. Delayed development of secondary sexual characters
3. Psychogenic
4. Hero worship of older boy or sibling
5. Excessive maternal protection
6. Non fusion of thyroid laminae
7. Increased laryngeal muscle tension causing laryngeal elevation
Complaints:
1. Unusual high pitched voice persisting beyond puberty
2. Hoarseness of voice
3. Breathy voice
4. Inability to shout
5. Vocal fatigue
The typical fundamental frequency of adult male voice ranges between 85-180 Hz and that of a typical adult female is about 165-255 Hz 4. In Puberphonia the boy continues to use a higher pitch which stresses the laryngeal mus-culature.Examination of these patients should include a complete physical examination including a geni-tal examination also. Secondary sexual charac-ters should be assessed, hypogonadism should be ruled out. A complete psychological profile of the patient in question should be built to rule out psychological causes. If psychological causes could be identified they treating it should take precedence over other modalities. These patients speak in a double voice, both in high pitch and low pitch.The impact of this voice disorder varies from person to person. This depends on the follow-ing variables
1. Occupation
2. Environment
3. Family members
4. Personality
Goals of treatment of Puberphonia:
1. The patient should be taught to phonate at a low pitch
2. The patient should be taught to fully utilise the Phonatory and Respiratory musculature
5. Vocal fatigue
5. Vocal fatigue
5. Vocal fatigue
Puberphonia is persistence of adolescent voice after puberty in the absence of organic cause. This common condition is seen in males. These patients have a high pitched voice. This article at-tempts to review published literature on this topic with specific focus on conservative management. This condition is also considered to be a psycho-genic voice disorder. Conservative management has met with excellent success. Conservative man-agement modalities for this condition ranges from voice therapy to laryngeal manipulation
Introduction:
The persistence of adolescent voice even after pu-berty in the absence of organic cause is known as Puberphonia1. This condition is commonly seen in males. This is uncommon in females because laryngeal growth spurt occurs commonly only in males. According to Banerjee the incidence of Puberphonia in India is about 1 in 900,000 pop-ulation 2. In females this condition is known as “Juvenile Resonance Disorder” or a “Little Girl’s Voice”. This condition is characterised by vocal instability with extensive frequency swing.
Pathophysiology:
In infants the laryngotracheal complex lies at a higher level. It gradually descends. During puberty in males this descent is rapid, the larynx becoming larger and unstable and on top of it the brain is more accustomed to infant voice.
The boy may hence continue to use a high pitched voice or it may break into higher and lower pitch-es 3.
Etiology: include
1. Emotional stress
2. Delayed development of secondary sexual characters
3. Psychogenic
4. Hero worship of older boy or sibling
5. Excessive maternal protection
6. Non fusion of thyroid laminae
7. Increased laryngeal muscle tension causing laryngeal elevation
Complaints:
1. Unusual high pitched voice persisting beyond puberty
2. Hoarseness of voice
3. Breathy voice
4. Inability to shout
5. Vocal fatigue
The typical fundamental frequency of adult male voice ranges between 85-180 Hz and that of a typical adult female is about 165-255 Hz 4. In Puberphonia the boy continues to use a higher pitch which stresses the laryngeal mus-culature.Examination of these patients should include a complete physical examination including a geni-tal examination also. Secondary sexual charac-ters should be assessed, hypogonadism should be ruled out. A complete psychological profile of the patient in question should be built to rule out psychological causes. If psychological causes could be identified they treating it should take precedence over other modalities. These patients speak in a double voice, both in high pitch and low pitch.The impact of this voice disorder varies from person to person. This depends on the follow-ing variables
1. Occupation
2. Environment
3. Family members
4. Personality
Goals of treatment of Puberphonia:
1. The patient should be taught to phonate at a low pitch
2. The patient should be taught to fully utilise the Phonatory and Respiratory musculature
5. Vocal fatigue
5. Vocal fatigue
5. Vocal fatigue
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