Puberphonia Causes, Signs & Symptoms, Diagnosis & Treatment
What is Puberphonia?
Puberphonia or Mutational Falsetto is the persistence of high pitched voice after puberty in the presence of a structurally normal larynx. The voice of a puberphonic is high pitched, breathy and hoarse sometimes associated with pitch breaks. Puberphonia is not a disorder that is likely to go away on its own. Without treatment, the changes in the patient’s voice can become permanent
Puberphonia is also known as functional falsetto. The laryngeal mechanism goes through a dramatic change in both males and females during puberty. The male voice lowers about one octave during mutation and the female voice lowers one to three semitones. When this acoustic change does not take place following the normal physical maturation, and individual is said to have functional falsetto. This occurs more frequently in males than females, but can occur with both.
What are the symptoms of Puberphonia?
The voice qualities associated with puberphonia include:
- high pitch
- low intensity
- breaks in phonation and frequency
- neck and throat tension
What causes Puberphonia?
Etiology of puberphonia include emotional stress, delayed development of secondary sexual characters, psychogenic, hero worship of older boy, maternal protection, etc. Puberphonia may also be because of nonfusion of thyroid laminae, in these cases hypogonadism may be the cause and it has to be ruled out.
Apart from the above conditions, various other factors for which this retention of the child’s voice can be possible, as suggested by most of the health professionals in India:
- Late development of sexual maturity
- Hypogonadism – which refers to the reduction or the complete absence of hormone secretion or some other complexes in the physiological activity of the gonads (testes or ovaries), as a result of which these fail to function properly.
- The desire to retain this singing voice, which incorporates in the person a feeling that the loss of this voice might lead to loss of attention.
- Hero worship of older boy or sibling
- Non fusion or the underdevelopment of the thyroid laminae
- Emotional stress
How does it Occur?
The person suffering from Puberphonia normally does not have any underlying anatomical abnormalities. That is to say that the laryngotracheal complex which initially lies at the highest level during childhood adolescent stage, and gradually descends as the child hits puberty, is quite normal. The descendancy (which is slow for females and quite fast in the case of males) too is quite normal, along with the overall laryngotracheal structure. Trained and professionals at any well-known voice disorder treatment clinic in Kolkata strongly believe that Puberphonia is rather psychogenic in nature – that is, it stems out of various mental stresses or psychological disbalances or complexities. It occurs due to the inappropriate use of the voice habitually. It commonly occurs due to person’s constant contact with female members at home or even elsewhere. Hence, they tend to adopt that female-like voice and due to habitual use of such a high-pitched voice, they develop it.
However, Freudian psychology explains puberphonia with Oedipus Complex, which involves the male child being attracted towards the female parent. In such a case, the son’s love for the mother becomes strong. This strong bond between the mother and the son leads to over-dependence of the child on the mother, thus fearing to take up responsibilities. This in turn develops a notion in them that the father is a threatening figure, so this grows in the child a feeling of hatred towards the male parent. As a result, he starts denying sexual maturity and masculinity, and hence denies using the mature male voice. The child hence, gradually develops the habit of speaking in the high-pitched female voice.
What are Major Treatment Methods?
At any distinguished voice disorder treatment clinic in Kolkata, Puberphonia is usually treated by either or a combination of the following methods of treatment –
- Voice Therapy
- Larynx Manipulation
- Surgical Therapy
Treatment Type-1: Voice Therapy
The primary treatment of a voice disorder like Puberphonia is speech therapy done by a professional and highly trained Speech Language Pathologist at a recognised voice disorder treatment clinic in Kota (Rajasthan) like Mahavir ENT Hospital.
First the symptoms are examined, along with genital examination and the assessment of secondary sexual characters. If some hormonal issue is the case, then effort is given on ruling out hypogonadism. However, if the problem is psychogenic in nature, then effort is first put on eradicating these psychological issues, mainly by counseling. Then accordingly the certified Speech Language Pathologist goes on with undergoing regular speech and voice therapy sessions so as to correct the voice disorder, and to develop in the sufferer a masculine voice.
The voice therapy sessions at any renowned voice disorder treatment clinic in Kota, includes
- Teaching the person suffering with Puberphonia to produce a low-pitch voice while speaking.
- Teaching the person how to use his Phonatory and Respiratory musculature fully.
- Teaching the person how to manipulate his voice well
- The person should be given enough motivation so that he might be convinced that the new low-pitch voice should be used instead of the high-pitch one.
Treatment Type-2: Larynx Manipulation
External laryngeal manipulation (ELM) is used to get better laryngeal view during direct laryngoscopy. External laryngeal manipulation (ELM) is a simple maneuver that facilitates laryngeal visualization during laryngoscopy. It coordinates the operator’s right hand with what it is being simultaneously visualized, allowing fine tuning of the manipulation to maximize the laryngeal exposure. ELM has been shown to improve laryngeal exposure and makes better intubating conditions. ELM used to be done by the intubating person to guide the assistant to the best way of doing it to maximize the laryngeal view.
Treatment Type-3: Surgical Treatment / Thyroplasty
This is the most advanced and highly effective treatment of Puberphonia. Unlike Voice threapy you need not to visit hospital or speech thraphy centre for multiple sittings where the result is not guarenteed. Or unlike Larynx Manipulation is not painful. Larynx Manipulation is not for faint hearted patients. Thyroplasty is the best treatment available for Puberphonia problem. It is a surgical procedure. After thyroplasty a male get a male voice back and his voice no more sounds like females.
What is Thyroplasty?
Thyroplasty, arytenoid adduction, and injection laryngoplasty are surgical procedures to move a paralyzed or weak vocal fold (cord) closer to the center of the larynx in order to improve the voice. Thyroplasty is a procedure performed to change the position of the vocal cord. This is usually performed to improve a patient’s voice and ability to cough.
The short procedure is performed under local anaesthesia and using intravenous sedation so that the surgeon can check the patient’s voice throughout the process. Thyroplasty is performed in the operating room with the patient asleep during parts of the surgery. A small cut is made on the neck and the voice box is identified. Through a small hole made in the voice box a Gore-Tex implant is placed to move the vocal cord into the proper position. During the surgery the patient is awoken and asked to speak in an effort to “fine tune” the voice box.
Patients typically stay one night in the hospital after surgery and full recovery takes about one week. Patients usually enjoy a significant improvement in function and quality of life.
Thyroplasty is an amazing and a magical option for Puberphonia treatment. Its results are magical and you may see this in various videos on this page.