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Puberphonia (also known as mutational falsetto) is the habitual use of high-pitched voice beyond puberty.[1]


The laryngeal prominence, commonly known as the Adam's Apple.

Typically, adolescent males undergo voice changes to a much lower pitch due to a sudden increase in the length and thickness of the vocal folds. Often this size change is noticed as the sudden enlargement of the larynx (aka "Adam's Apple" when viewed as a protrusion at the anterior of the neck). This is uncommon in females because their vocal folds do not show a sudden increase in size.[2]


Puberphonia is the functional, habitual use of high-pitched voice post puberty after the vocal folds have reached typical adult size. The muscles directly alongside the larynx become too tight, which causes the patient to constantly speak in falsetto. The condition does not go away on its own, and requires physical therapy to correct. This condition is seen in males more often than in women. Puberphonia is also more noticeable in men than women because men are expected to speak much lower than women, and less noticeable in women because women typically speak much higher than men.

Well-known sufferers[edit]

Singer Michael Jackson, heavy metal singer Glenn Danzig, cricketer Mike Gatting, boxer Chris Eubank, politician George Osborne.


  • Emotional stress
  • Delayed development of secondary sexual characteristics
  • Psychogenic
  • Skipped fusion of thyroid laminae


Voice therapy

This condition is best treated by voice therapy (vocal exercises) by speech-language pathologists (SLPs) /speech therapists having experiences in treating voice disorders because puberphonia is not a very common problem. The duration of treatment can usually be one to two weeks.[3]

It includes:[4]

  • Cough
  • Speech range masking
  • Glottal attack before a vowel
  • Relaxation techniques to relax the laryngeal musculature
  • Visi pitch
  • Lowering of larynx to appropriate position
  • Humming while sliding down the scale
  • Half swallow Boom technique
Larynx manipulation

Type III phonosurgery can be done, which includes surgical shortening and relaxation of the vocal cords.[5]


The incidence of puberphonia in India is estimated to be about 1 in 900,000 population.[6]


  1. ^ Vaidya, S; Vyas, G (Jan 2006). "a" (PDF). Indian J Otolaryngol Head Neck Surg. 58 (1): 20–21. PMC 3450609Freely accessible. PMID 23120229. doi:10.1007/BF02907732. 
  2. ^ Aronson, Arnold Elvin; Bless, Diane M. (2009). Clinical Voice Disorders. 
  3. ^ Boone, Daniel R.; MacFarlane, Stephen C.; Von Berg, Shelley L.; Zraick, Richard I. (2010). The voice and voice therapy. Allyn & Bacon. 
  4. ^ Balasubramanian, Dr. T. "Puberphonia and its management by drtbalu". Retrieved 1 November 2016. 
  5. ^ Puberophonia-surgical management with modified ishiki thyroplasty type III Der Pharmacia Lettre, 2014, 6 (2):77-81
  6. ^ Banerjee AB, Eajlen D, Meohurst R, Murthy GE (1995) Puberphonia – a treatable entity. world voice congress oporto portugal

External links[edit]