Dysphonia during voice mutation

During the period of voice mutation, erythema may appear due to the action of somatotropin on the growing larynx. The result is often a falsetto and/or a transient adolescent dysphonia that causes the teenager to maintain a childlike voice with a very high fundamental frequency, even after sexual maturation. This happens because it’s the only range of frequencies they are used to and capable of controlling.

However, when producing other vocalizations such as laughing, coughing, or crying, a deeper voice may emerge.

This type of dysphonia is associated with laryngeal hypertonia and excessive contraction of the cricothyroid muscles, resulting in increased vocal fold length. This excessive tension leads to a decrease in the thickness of the vocal folds, which, combined with the loss of respiratory mechanical strength, produces a voice characterized by a high pitch and weak quality.

Often, the laryngeal diameters close excessively, reducing the ability of the vocal cords to vibrate.

Vibration is thus limited to the edge of the vocal fold, and, combined with the elevation of the larynx caused by excessive contraction of the suprahyoid muscles, this reduces tonal flexibility and the ability to project the voice.

The larynx elevates, thereby shortening the vocal tract. All of these aspects result in a higher-pitched sound.

Furthermore, the patient typically exhibits vocal effort and phonasthenia, along with a reduction in vocal efficiency.

Excessive laryngeal constriction and tension, typical of high-pitched vocal production, can lead to the formation of pathological elements in the glottic region, such as nodules and edema. This condition, where improper voice use leads to lesions of the glottic structure, is classified as functional organic dysphonia.

In terms of etiology, the following factors can be identified:

• Emotional tension

• Delayed development of secondary sexual characteristics

• Overprotective maternal behavior

• Strong feelings of female attachment

• Increased laryngeal muscle tension, causing laryngeal elevation

A collaborative approach between the speech therapist and the osteopath can help accelerate the descent of the larynx, support integration within the growing body, and aid in the acquisition and control of new vocal frequencies.

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Valentina Carlile - Osteopath specializing in Osteopathy for Voice and Speech Disorders since 2002. For information and bookings, visit the Contact page.

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