Puberphonia
There is a higher male prevalence of puberphonia, as the voice disorder is characterized by a high pitch that would be inappropriate for the age and sex of the patient.
Instead, the disorder is usually psychogenic in nature, meaning resulting from psychological or emotional factors,[3] and stems from inappropriate use of the voice mechanism.
However, the larynx descends and grows significantly larger in males which often results in a visible laryngeal prominence on the neck (Adam's apple).
[12] The most common presentation of the condition is characterized by a normal adult larynx and an increased pitch due to the vocal folds adopting the falsetto position.
[12] To determine whether a patient presents with puberphonia, a complete voice assessment including medical and diagnostic evaluations is recommended.
[6] A behavioural assessment for puberphonia will consist of several types of tasks, and may include: Clinicians can also request a self-assessment, in which the patient describes their symptoms and their effects on activities of daily living.
[6] The clinician may direct this self-assessment to include the identification of personality traits that may maintain the disorder, the social and emotional consequences of the symptoms experienced, and whether the patient has any access to their modal voice register.
[4][15] A complete assessment for puberphonia or any other voice disorder may require a referral to another healthcare professional, such as a psychologist or a surgeon, to determine candidacy for various treatment options.
[14] Incorporating audiovisual feedback in speech and voice therapies has been successful in intervention by improving motivation and guidance.
This can occur in situations where intervention is delayed or the patient is in denial, causing the condition to become resistant to voice therapy.
[21] There are different types of surgical interventions which have been successful in lowering the vocal pitch in men with puberphonia who had previously received ineffective voice and psychotherapy.
The first surgical intervention developed, called relaxation thyroplasty or tetrusion thyroplasty, involves a bilateral excision of 2 to 3 mm vertical strips of thyroid cartilage which lowers the vocal pitch through anteroposterior relaxation and shortening of the vocal folds.
