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      Mutational falsetto: intervention outcomes in 45 patients

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          Abstract

          Objective:

          The aim of this study was to evaluate the outcomes of therapeutic intervention in patients with mutational falsetto, by applying perceptual and acoustic analysis before and after voice therapy.

          Materials and methods:

          Forty-five consecutive patients with mutational falsetto were studied retrospectively. Acoustic analysis (i.e. fundamental frequency, jitter, shimmer, and formants one, two and three) was performed using the Multi-Dimensional Voice Program. Perceptual voice analyses were performed, including graded severity–roughness–breathiness–aesthenicity–strain assessment.

          Results:

          Subjects' fundamental frequency, voice formants one, two and three, jitter, and shimmer were greater before than after treatment. There were statistically significant differences between pre- and post-treatment average values for fundamental frequency, jitter and shimmer. There were also statistically significant differences between pre- and post-treatment average values for formants one and two. These results were maintained after six months of follow up, and there was no significant difference between results at three- and six-month follow up. According to perceptual evaluation, each subject's voice had altered from mutational falsetto to chest voice by completion of the intervention. Thus, all of the patients successfully lowered their modal speaking voice to an appropriate level.

          Conclusion:

          In the light of objective evaluations, and by applying the study treatment protocol, these results suggest that normal voice can be maintained after intervention, at six months' follow up.

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          Most cited references14

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          Test-retest study of the GRBAS scale: Influence of experience and professional background on perceptual rating of voice quality

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            Muscle misuse voice disorders: description and classification.

            It is apparent that voice disorders frequently labelled "functional" are associated with laryngeal muscle misuse. This use of the word "functional" is, however, intrinsically ambiguous, and so we propose an alternative term based on descriptive features of dysfunction: "muscle misuse voice disorders". Persistent phonation with an abnormal laryngeal posture can lead to organic changes such as nodules or polyps, particularly in females with posterior glottic chink. We hypothesized that the chink was related to an overall increase in laryngeal muscle tension, and more directly due to inadequate relaxation of the posterior crico-arytenoid muscle during phonation. We employed the term "muscular tension dysphonia" (MTD) to note this condition, but it may be that the term "laryngeal isometric" is superior since there are other misuses of the larynx that obviously are manifestations of abnormalities of muscular tension. With this in mind we have evolved a new classification based on the laryngeal isometric, glottic and supraglottic lateral contraction states, antero-posterior contraction states, conversion aphonia, psychogenic bowing, and adolescent transitional dysphonia.
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              Growth of the human prepubertal and pubertal larynx.

              Prepubertal, pubertal, and adult measurements of human larynges were used to describe growth of the larynx from prepuberty to adulthood. Linear and weight measurements made of 10 Caucasian male and 10 Caucasian female prepubertal and pubertal cadaveric larynges were compared to adult measurement data obtained from another study on 20 male and 20 female larynges of adults, aged 37-70. In both studies measurements and experimental protocols were similar, allowing direct comparisons to be made between samples. Results highlight specific quantitative characteristics and trends in circumpubertal growth of the laryngeal cartilages and the vocal folds for each sex and with respect to sex differences. The results are discussed with respect to the literature on postnatal laryngeal development and to published research on adolescent voice change.
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                Author and article information

                Journal
                The Journal of Laryngology & Otology
                J. Laryngol. Otol.
                Cambridge University Press (CUP)
                0022-2151
                1748-5460
                March 2008
                May 25 2007
                March 2008
                : 122
                : 3
                : 277-281
                Article
                10.1017/S0022215107008791
                5952ce45-5a82-419e-a10a-19cafcd3f760
                © 2008

                https://www.cambridge.org/core/terms

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