​Correlation Between Fundamental Speech Frequencies (F0) And Serum Testosterone Levels In Patients With Puberphonia Attending A Tertiary Care Hospital

ABSTRACT

Background: voice in humans is susceptible to the hormonal changes throughout life right from the puberty until old age. Thyroid,gonadal, and growth hormones have varied impact on the structure and function of the vocal apparatus. Voice changes are observedduring physiological states such as puberty and menstruation. Puberphonia is defined as an inappropriate use of high-pitched voicebeyond pubertal age in males which is usually seen in the immediate postpubescent period when the male vocal mechanism hasundergone significant changes in size and function caused by hormonal changes. Endocrine evaluations in puberphonia by astuteclinical observers who make out the changes in the voice are required to develop a system of diagnosis and assessment of prognosis.Aim of the study The aim of the study was to analyze the relationship between serum testosterone levels and fundamentalfrequencies (F0) of patients with puberphonia.Materials and Methods: A total of 43 patients aged between 14 and 18 years with puberphonia were included in the study.They were subjected pubertal history taking and an ENT evaluation with a stroboscope to obtain visual assessment of the vocalcords. The mucosal wave, vibratory symmetry, and amplitude; type of glottic closure; hyperfunction; arytenoids movement andsymmetry; ventricular movement, etc., were evaluated using stroboscopy including patient’s fundamental frequency (F0) duringsustained phonation. The relationship between circulating levels of serum testosterone and the fundamental frequencies ofpuberphonia patients was analyzed. Serum testosterone was evaluated by quantitative high-performance liquid chromatographytandem mass spectrometry method in this study. Serum levels of testosterone more than 165 ng/dL in children aged 14–15 years;testosterone levels higher than 619 ng/dL in children aged 15–16 years; and higher than 733 ng/dL in children aged 16–17 yearswere taken as abnormal. All the data were analyzed using standard statistical methods.Observations and Results: Among the 43 patients, the incidence was equal in all age groups between 14 and 17 years. Therewas no statistical significance in relation to socioeconomic status, the presence of secondary sexual features, personality, andparent domination among the groups. However, residing in urban locality was statistically significant over residence in the rurallocality among the patients with puberphonia with P = 0.042 and 0.038, respectively. The overall F0 mean value for the studygroup was 196.56. The relationship between mean F0 values and mean serum Testosterone levels were analyzed using Chisquare test and observed that there was statistical significance between the values in all the age groups of the study (P < 0.05).Conclusions: There was a negative relationship between circulating levels of serum testosterone and fundamental frequency(F0). Higher testosterone levels are indicating lower fundamental frequency, although the magnitude of the relationship waslarger than previously observed studies in literature. It is thought that male voices may have deepened over the course ofevolution to signal dominance and/or to increase the speaker’s attractiveness. Findings confirm that vocal frequencies mayprovide an honest signal of the speaker’s hormonal quality.