uvula is equal to vocal cords

The process of phonation converts aerodynamic energy into acoustic energy: It can occur not only vocal cords but also at the level of uvula, where the nasopharyngeal & oropharyngeal opening is there and uvula vibration is there like vocal cords

Supra laryngeal valves

Kumaresan & Navin Bharath three articles are given in the reference in Journal of voice:

March 29, 2024

Open access

Accessibility to Puberphonia Online and Its Readability by Patients

Maryam Aljawi aljawim@clevelandclinicabudhabi.ae ∙ Anastasios Hantzakos HantzaA@ClevelandClinicAbuDhabi.ae

puberphonia in USA publication

Kumaresan & Navin Bharath three articles are given in the reference in Journal of voice:

March 29, 2024

Open access

Accessibility to Puberphonia Online and Its Readability by Patients

Maryam Aljawi aljawim@clevelandclinicabudhabi.ae ∙ Anastasios Hantzakos HantzaA@ClevelandClinicAbuDhabi.ae

puberphonia

In puberphonia we get 100 percent successful for those puberphonia boys who want to change chair voice. Failure is there who never wants to change. Habit is a habit. They want to be homosexual. Uvula manipulation (uvular voice) is lower in pitch. Continue the uvular voice by abdominal breathing exercises (a small technique). Overall the laryngeal phonation should be redirected to pharyngeal phonation. ( Phonation- air flow energy to be converted to voice ). Phonation doesn't mean it happens in the vocal cords. It is a controversial subject because, still speech training is an art and not science.

News

I am Dr. Kumaresan, a retired ENT Specialist and Professor from Stanley Medical College. We are now focusing on treating puberphonia, a condition where boys speak in a female tone. This problem is not widely recognized in the medical community. Through our research, we have discovered that uvula manipulation can effectively treat puberphonia.

We have successfully treated over 1,500 patients using this method. Our treatment does not involve surgery or medication, only a scientific approach of manipulating the uvula. This treatment not only corrects the voice but also helps restore the male character.

To maintain the treated voice, we also provide a unique five-day abdominal breathing exercise program, which we developed through our own research. These exercises are not found in any medical books but have shown excellent results. After completing the program, both the patients and we are very satisfied with the outcomes.

To all my dear social media influencers, we need a small help from your side. We would greatly appreciate it if you could help spread awareness of this breakthrough treatment so that we can take it forward to more people in need.

Social Media:

YouTube: Puberphonia Treatment

Instagram: Dr. M. Kumaresan MS DLO

Facebook: M Kumaresan

Prof. Dr. M. Kumaresan

MS(DLO), ENT Surgeon

Dr. K. Navin Bharath

MBBS, MS.ENT Surgeon

Website: www.sivaent.com

Email: kumaresan@doctor.com

Cell / Handphone: +91 9841055774

SIVA ENT HEAD AND NECK HOSPITAL

94 (New No: 159), Avvai Shanmugam Salai (Lloyds' Road),

Royapettah, Chennai - 600 014, India.

Phone: (044) 28116807

Thank you.

Dr. M. Kumaresan

- Dr. M. Kumaresan MS ENT

puberphonia

Uvula manipulation- a recognised treatment for puberphonia.

__________________________

Puberphonia, a condition where someone has a voice that sounds like a child's even into adulthood. Speech therapists use a variety of techniques to help people with puberphonia lower their voice, including: 

Humming: Humming while gliding down the pitch scale helps relax the laryngeal muscles and practice using a lower pitch. 

Glottal attack: Involves pushing air through closed vocal cords to produce vowel sounds. 

Coughing: Applying pressure to the Adam's apple and coughing shortens the vocal folds and lowers the pitch. 

Speech range masking: Involves speaking while a loud noise plays, then listening back to a recording of the voice. 

Thyroid cartilage manipulation: Involves gently pushing on the thyroid cartilage while producing a vowel. 

Uvula manipulation and resonance: Involves practicing voicing at a lower pitch with forcible airflow from the diaphragm.

Puberphonia

The meeting 1.11.2024

-----புதுப்பிக்கப்பட்ட நம்பிக்கை----

 Participation 40 members.

 It was organised by வரலாற்று ப் பேரவை at Siva ENT, Royapettai 

We decided to have further meetings on last Saturday of every month with lunch & evening snacks, a "Free voice/puberphonia /e,AI program with students & public & research with Tamil schoolers ". We look forward your whole hearted cooperation. Those who are interested in working as committee members, please inform me in 9841055774.

- Dr. M. Kumaresan MS ENT

puberphonia

Hi sir 

I am from Thiruvarur my age is 21

My name is s+++++++

My voice is not break down my childish voice and female voice

I am currently studying college in coimbatore

My problem is my voice I am not speak any one 

my confidence level is down because my voice.

I am daily crying in my voice I s female voice maari iruku.

You come to coimbatore.

Reply by DrM.kumaresan.

For Hindi +917416347435

Sekar. शेखर

डॉ.एम.कुमारेसन एमएस ईएनटी

शिवा ईएनटी हेड एंड नेक हॉस्पिटल

प्रथम तल, 159, लॉयड्स रोड, रोयापेट्टा, चेन्नई।

विपक्ष: एडीएमके कार्यालय

मोबाइल: +917416347435

https://maps.app.goo.gl/rxBJrr8Yw7yTdzs86

आना।

प्यूबरफोनिया 5 दिन/- 10 हजार रु. आवास रु. 300/दिन। रविवार की छुट्टी।

बस 21 चेन्नई सेंट्रल एमजीआर रेलवे स्टेशन से अजंता स्टॉप तक

लॉयड रोड में एआईएडीएमके कार्यालय के सामने फोर्थ बिल्डिंग

कार्य के घंटे: सुबह 11:00 बजे से शाम 6:00 बजे तक

- डॉ. एम. कुमारेसन एमएस ईएनटी

English 91 9841055774

Dr.M.Kumaresan MS ENT

Siva ENT Head & Neck Hospital

First Floor, 94, Lloyd's Road, Royapettah, Chennai.

Opp: ADMK Office

Mobile: 98410 55774

https://maps.app.goo.gl/rxBJrr8Yw7yTdzs86

No Appointment Required

Puberphonia 5 days ₹10,000/- Accommodation in the hospital Rs.300/day. Food outside the hotel.

Bus 21 From Chennai Central MGR Railway Station to Ajantha Stop

Forth building opp AIADMK Office in Lloyd's Road

Working Hours: 11:00 am to 6:00 pm except Sunday.

- Dr. M. Kumaresan MS ENT

uvular voice

voiceless uvular plosive or stop is a type of consonantal sound, used in some spoken languages. It is pronounced like a voiceless velar plosive [k], except that the tongue makes contact not on the soft palate but on the uvula. Uvula modulates the sound.

Dr.M.Kumaresan

puberphonia

Google enumerated the treatment for puberphonia with our method of " uvula manipulation". 

There are a number of ways to correct puberphonia, a voice disorder that can cause a high-pitched voice, including:

Manual larynx adjustment: A lower-pitched voice can be achieved by manually moving the larynx down, which relaxes the vocal folds and makes the voice deeper.

Vocal exercises: These include:

Yawning and sighing: Relaxes the laryngeal muscles

Humming while lowering pitch: Starts at the highest pitch and gradually lowers it

Half swallow boom: Say "boom" after swallowing, then repeat while turning the head and lowering the chin

Glottal fry: Produce the lowest pitch possible

Glottal attack: Forcefully start the voice when producing vowels

Uvula manipulation and resonance: This technique involves practicing uvula resonance with forcible airflow from the diaphragm or stomach

Counseling: This can help identify psychological factors

Education: This can help with good vocal hygiene

Audiovisual feedback: This can use a graphical representation of the voice 

 

Other treatments include Botox injections and surgery. Hindi +917416347435

Sekar. शेखर

डॉ.एम.कुमारेसन एमएस ईएनटी

शिवा ईएनटी हेड एंड नेक हॉस्पिटल

प्रथम तल, 159, लॉयड्स रोड, रोयापेट्टा, चेन्नई।

विपक्ष: एडीएमके कार्यालय

मोबाइल: +917416347435

https://maps.app.goo.gl/rxBJrr8Yw7yTdzs86

आना।

प्यूबरफोनिया 5 दिन/- 10 हजार रु. आवास रु. 300/दिन। रविवार की छुट्टी।

बस 21 चेन्नई सेंट्रल एमजीआर रेलवे स्टेशन से अजंता स्टॉप तक

लॉयड रोड में एआईएडीएमके कार्यालय के सामने फोर्थ बिल्डिंग

कार्य के घंटे: सुबह 11:00 बजे से शाम 6:00 बजे तक

- डॉ. एम. कुमारेसन एमएस ईएनटी

English 91 9841055774

Dr.M.Kumaresan MS ENT

Siva ENT Head & Neck Hospital

First Floor, 94, Lloyd's Road, Royapettah, Chennai.

Opp: ADMK Office

Mobile: 98410 55774

https://maps.app.goo.gl/rxBJrr8Yw7yTdzs86

No Appointment Required

Puberphonia 5 days ₹10,000/- Accommodation in the hospital Rs.300/day. Food outside the hotel.

Bus 21 From Chennai Central MGR Railway Station to Ajantha Stop

Forth building opp AIADMK Office in Lloyd's Road

Working Hours: 11:00 am to 6:00 pm except Sunday.

-

- Dr. M. Kumaresan MS ENT

Kumaresan voice index

TRAIT

Authors

• Dr. K. Navin Bharath
• Dr. M. Kumaresan

Abstract

Abstract: Puberphonia is a common vocal disorder characterized by the persistence of high vocal pitches after puberty. It is necessary to evaluate the puberphonia patient's voice quality. The emergence of “Puberphonia eradication clinics” in practice at SIVA ENT Hospital, with a treatment of 1400 cases of puberphonia, necessitates the development of standard protocols for the assessment of puberphonia voice disorders. ENT surgeons, speech therapists and otolaryngologists often use GRBASI scale. G-grade, R-roughness, B-breathiness, A-asthenia, S-strain, and I-instability make up GRBASI scale, which is used to evaluate voice quality. A patient's history, physical exam, visual and perceptual evaluations, and self-evaluation of voice were all part of the process. Additionally, the patient and ENT surgeon reached an agreement on the diagnosis and course of treatment. As such, it mainly serves to provide doctors with a means of communicating the seriousness of auditory-perceptual features associated with puberphonia voice problems. Its secondary objective is to assess the need and add to theories on the physiological and anatomical foundations of voice disorders. People who are impacted may face social obstacles that greatly impact their quality of life. The alterations in the voice can only be felt, not measured or recorded, from a clinical perspective. Since this is an objective measurement of the speech change, we need a simple device or instrument to record it. The otorhino laryngologist will conduct a perceptual evaluation, during which the patient or parent will be asked about the impact of puberphonia dysphonia on everyday life.

Key Words

Puberphonia, voice satisfaction, perception of voice, quality of voice, GRBASI, Kumaresan voice index

Cite This Article

"A NEW PUBERPHONIA VOICE INDEX TO ASSESS THE QUALITY OF VOICE TO FULFIL THE PERSONALITY TRAIT", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.11, Issue 6, page no.i194-i200, June-2024, Available :http://www.jetir.org/papers/JETIR2406820.pdf

ISSN

2349-5162 | Impact Factor 7.95 Calculate by Google Scholar

cause of puberphonia voice

Cause of puberphonic voice. Puberty time boys may have continued children's voices. They speak in low voice. Too much nasal resonance makes the voice nasal sounding.

The fear of nasal resonance causes many people to use lower throat resonance. Forced lower throat/ laryngeal resonance causes voice problems, including tired voice, hoarseness, lack of carrying power, and other negatives associated with a wrong voice.

Treatment.

Nasopharyngeal cavity resonance is not only the key to a winning voice, but also voice health and longevity of voice. It provides carrying power, strength, and durability of tone. 

Dr.M.Kumaresan.

Double voice

Our findings in treating various voice disorders. We have treated more than 50 double voice patients. We found one voice is a pharyngeal voice and another is a laryngeal voice.

Dr.M.Kumaresan

9841055774

Existing belief:

Diplophonia/ diphthongia- two sounds of different pitch, cause- quasi - periodic vibration of the vocal cords, but no uniform interpretation of established mechanism. (Quasiperiodic+ almost periodic.)

Creation of words

In Tamil language உயிர் எழுத்துகள் are created byu vula: மெய்எழுத்துகள் are created by vocal cords: இவ்வாறு பன்னிரண்டு உயிர் எழுத்துக்களும் பதினெட்டு மெய் எழுத்துக்களுடன் சேர்வதால் (18 X 12) 216 உயிர் மெய் எழுத்துக்கள் பிறக்கின்றன. So now only it is the combination of uvular and vocal sound.

puberphonia

Treatment for puberphonia.We don't do speech therapy. I do voice rehabilitation. . During vocal rehabilitation, pitch, volume, quality, breath support and the vocal image are realigned to afford an optimal and efficient voice. redirecting laryngeal jivoice to pharyngeal voice. Adjusting the voice placement. Placing the voice in the naso pharyngeal cavity and producing uvular sounds and abdominal breathing. Resonate in the nose and sinuses.

Our findings

The fear of nasal resonance causes many people to use lower throat resonance. Forced lower throat resonance causes voice problems, including tired voice, hoarseness, lack of carrying power, and other negatives associated with a wrong voice. Nasopharyngeal cavity resonance is not only the key to a winning voice, but also voice health and longevity of voice. It provides carrying power, strength, and durability of tone. It gives you everything you ever wanted in your voice and more. Balanced resonance allows you to project your voice with more or less volume, with ease and comfort. This is the technique good public speakers and talented actors rely on when on stage without a microphone.

Dr.Raja

Sir,

Excellent and very effectively it has been treated the condition puberphonia into the normal male voice in short time.

It is really useful and helpful in solving psychologically !

Thank you very much.

I will keep in contact you and thank you for sharing the video clipping .

--Dr. Raja.

Kumaresan remady

[5/2, 8:28 AM] Dr. M. Kumaresan MS(ENT): Place the voice in the mask area- the naso-pharyngeal cavity aum "ஓம்". Adult voice break-male puberty, the glimpse of manliness you feel in your life.

: Surgical landmark of "nasopharyngeal cavity" - mask area.

: At birth in the level of vocal cords voice break-cry, the glimpse of life you see in the body.

: Laryngeal speech - feel the vibrations in the neck and chest. Pharyngeal speech - feel the vibration in the ear and head.

puberphonia

Today 6.4.2024, special message by Dr.M.Kumaresan MS(ENT), DLO. in "YouTube Dr m Kumaresan".at 5 pm to 5.30 pm, Topic:Special Free Summer Camp

 starts from 13.4.2024-in SIVA ENT  Hospital, குரல் அரங்கு* A/C Conference Hall, 4 pm to 6 on, for one month. Study material will be given. Certificate provided. Every day competition & prizes for students who excel in VR and AR in VOICE. We teach regular classes on VR & AI computer based live learning from 4 to 6 pm daily.

We treat voices in puberphonia, Parkinson, dementia, paralysis, congenital total loss of hearing , post thyroid and many more larynx problems. We also do the needful for teachers, singers and speakers with voice problems.

puberphonia research

I am concentrating only on puberphonia.

My recent research:

Fast-track identification and treatment for puberphonia

Puberphonia is not a disease, but a speech problem may lead to many socioeconomic problems. In clinical practice, the voice can be described as hoarse, rough, raspy, strained, weak, breathy, or grave.  According to the first voice symptom enumerated by puberphonia boys,

1. Inaudible: 27%
2. Vocal fatigue: 22%
3. Child voice: 11%
4. Female voice: 10%
5. Double voice: 9%
6. Nasal voice: 7%
7. Not a strong voice: 7%
8. High-pitched voice: 5%
9. Hoarseness: 1%
10. Breathy voice: 1%

The symptoms can range from benign to badly dangerous. Because there is no organic change in the vocal tract, the disorder is grouped under psychogenic voice disorders; that is, it stems from various mental stresses, psychological misbalances, or complexities that lead to mental, emotional, and physical disabilities.

According to the symptomatology, puberphonia can be divided into benign and grave. Puberphonia is not a disorder that is likely to go away on its own. Without treatment, the changes in the patient’s voice can become permanent.

First, the symptoms are examined, along with the genital examination and the assessment of secondary sexual characters. If some hormonal issue is the case, then effort is made to rule out hypogonadism. However, if the problem is psychogenic in nature, then effort is first put into eradicating these psychological issues, mainly through counselling.

The Major Treatment Methods by which the puberphonia is usually treated by either or a combination of the following methods of treatment –Voice therapy or Larynx manipulationor surgical therapy. When there are a host of hassle-free treatments, such as uvula manipulation and resonance training for puberphonia, why not go for them? Voice is a vital aspect of one’s life, and it has a great impact in every field of our lives.

Research publications in national and international journals

A book published by Dr. M. Kumaresan M. Clinical and Practical Otorhinolaryngology: A Research Work in Otorhinolaryngology. 1st edn. Madras: Paramkalyan printers.

1. From the classic to the modern experience of puberphonia, 1. Navin Bharath K., 2. Muthiah Kumaresan International Journal for Research Trends and Innovation, IJRTI International Journal (ISSN: 2456 3315) 20/08/2023
2. Assess the Impact of Puberphonia in the Society, Int J Otorhinolaryngoogyl, 2019 Science article. Muthiah Kumaresan,Science Publishing Group.com May, 2019.
3. An immediate and permanent cure for puberphonia www.researchgate.net › amp Muthiah Kumaresan, Journal of eISSN: 2379-6359, Otolaryngology-ENT Research, Published: July 31, 2018.
4. Fast Track Treatment for Puberphonia, Kumaresan M* and Navin Bharath, Published: February 5, 2020 Scholarly Journal of Otolaryngology (SJO)
5. Uvula Manipulation and Resonance (UMAR) Treatment for Puberphonia, Original Article,Open Access, 74, 4954–4961 (2022), Muthiah Kumaresan, Kumaresan Navin Bharath,and Elangovann Parameswaren
6. Psycho-Cybernetics of Puberphonia Boys: Few Devastating and Remedy OSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 22, Issue 12, Ser. 1 (December. 2023), PP 07-13, www.iosrjournals.org, DOI: 10.9790/0853,212010713 www.iosrjournals.org 7 | Page, Dr. K. Navin Bharath,Dr. M. Kumaresan.
7. The Classic to the Modern Experience of Puberphonia, 1. Navin Bharath K. 2 Muthiah International Journal for Research Trends and Innovation IJRTI International Journal (ISSN: 2456-3315) 20/08/2023.

Prof. Dr. M. Kumaresan MS(DLO), ENT Surgeon.
Website: www.sivaent.com
E-mail: kumaresan@doctor.com
Cellular / Handphone: +91 9841055774

SIVA ENT HEAD AND NECK HOSPITAL
94(New No:159), Avvai Shanmugam Salai (Lloyds' Road),
Royapettah, Chennai- 600 014, India.
Phone : (044) 28116807

SIVA ENT CLINIC
295(New No:136), Quaid-e-Milleth Salai (Triplicane High Road),
Triplicane, Chennai- 600 005, India.
Phone : (044) 28546086

Saturday online eradication program 16/03/2024

Saturday 16.03.2024, 5 pm, "puberphonia / Voice care centre" A good news - Multidisciplinary Centre providing vocal rehabilitation for complex voice issues with free voice library. SOON!!!

Join at 5 pm this Saturday "YouTube puberphonia Dr m Kumaresan".

- Dr. M. Kumaresan MS ENT,DLO.ENT Surgeon.

- Dr. M. Kumaresan MS ENT

Puberphonia

Saturday 09.03.2024, 5 pm, "puberphonia / Voice care centre" A good news - Multidisciplinary Centre providing vocal rehabilitation for complex voice issues with free voice library. SOON!!!

Join at 5 pm this Saturday "YouTube puberphonia Dr m Kumaresan".

- Dr. M. Kumaresan MS ENT,DLO.ENT Surgeon.

- Dr. M. Kumaresan MS ENT

AIR interview

Good afternoon sir, 

Your  recent  interview on " மகரக்கட்டு மருத்துவம் "  ( First part) will  be  broadcast,  on 07/2/2024 , wednesday  at 03.02pm  in  FM RAINBOW (101.4MHz ) and second part on 14.2.2024 at same time.  If there is any change in the schedule,  you will be informed immediately. 

Please  listen  it and  give  your  valuable feedback..

Have  a  good  day ..

RAJA, PROGRAMME EXECUTIVE, HEALTH SECTION, CHENNAI

guttural vouce

[1/19, 9:45 AM] Dr. M. Kumaresan MS(ENT): Currently, I am studying with a tongue flattened technique to create the space in the throat and lowering the larynx. I am a tenor and from what I have experienced so far, flattening the tongue has helped me a lot in changing high frequency. Puberphonia boys were unable to speak well until flattening the tongue and sending the jaw slightly back. This has created a pharyngeal voice (guttural voice).

[1/19, 9:47 AM] Dr. M. Kumaresan MS(ENT): speech?

In linguistics, speech sounds that start in the throat, like the consonants k and g, are called guttural consonants, and there are even guttural languages which contain many guttural sounds.

puberphonia, redirect phonatin

Redirecting phonation from the larynx to other vibrating structures in the vocal tract to treat puberphonia and a new assessment

Dr.M.Kumaresan and Dr.K.Navin Bharath, 9841055774, kumaresan@doctor.com 

Accepted finding 

No. 1. The longest established method of indirectly viewing the interior of the larynx is mirror laryngoscopy. In this procedure, the otolaryngologist places a laryngeal mirror against the patient’s elevated soft palate as he or she says ‘ee’ at a relatively high pitch only. Vocal cords produce only high-pitched voices. To make a low-pitched voice, we have to redirect phonation. Although this technique enables the larynx to be viewed at rest and during phonation, it does not permit an assessment of the larynx during connected speech (the presence of the laryngeal mirror in the oral cavity prevents speech). To get a low pitch, it is better to redirect phonation from the larynx.

No. 2: Puberphonia patients need a detailed ENT evaluation. A stroboscope was used to obtain a visual assessment of the vocal cords. A perceptual assessment of the patient's voice was done using the GRBAS scale. The Voice Handicap Index (VHI) was developed and validated by Jacobson et al. for various dimensions of a voice disorder to be quantified. Typically, this is achieved by means of scales. One of the most widely used scales in the UK and internationally is the GRBAS scale of the Japan Society of Logopaedics and Phoniatrics, which was given its introduction in Hirano (1981). This perceptual rating system contains five parameters: G (overall grade of hoarseness), R (roughness), B (breathiness), A (asthenic), and S (strained quality). The GRBAS scale is not fully comprehensive; it does not include parameters for vocal pitch, for example (Freeman and Fawcus 2000). Nevertheless, this scale is a reliable method of perceptual assessment that has also been shown to correlate with voice-related quality of life (Karnell et al. 2007; Jones et al. 2006).

This scale consists of judging voice quality on the basis of grade (G), roughness (R), breathiness (B), asthenia (A), and strain (S) in voice production. Assess the patient and hear their voice. On hearing the voice, the diagnosis is confirmed. Measure the patient’s frequency of speech with an Android cell phone. By demonstrating different speech frequencies, you can gain the patient's trust. 

Our method of perceptual assessment: The types of continued occurrence of voice in puberphonia:

Assessment before treatment

Ladies Voice: A sexy voice is warm and inviting. It feels as if it is spoken from the chest rather than the head. Its tones are pleasing and not at all nasal.

Child voice: when they talk about their feelings or express them in an appropriate way.

High Pitch: Women with relatively high-pitched voices are typically perceived as more feminine, younger, and more attractive.

Hoarseness is a condition marked by changes in the pitch or quality of the voice, which may sound scratchy or husky.

Breathy voice: A breathy, airy singing voice means too much air, with the sound of voice escaping through the mouth. This causes a soft, breathy tone that's hard to hear.

Vocal fatigue, loss of intonation or expression,

Double Voice: The chest voice is your lower range, while the head voice is your higher range. The reason why people often feel like they have these two different voices that don't connect is because they have not developed their mix (of their middle register or middle voice). The mix is the bridge between the low and high vocal ranges.

The nasal voice is inappropriate because it increases airflow through the nose during speech.

Indifferent voice, having no preference, or being uninterested, since one doesn't want to indicate having any strong feelings

Inaudible Sound: The simplest noise reduction works primarily by lowering efforts to talk.

Our voice index before treatment: assessing the patient's statement

All have 10 qualities of voice, mostly mixed.

1.Child voice: 40%

2.Female voice: 39%

3.Double voice: 10%

4.High-pitched voice: 1%

5.Breathy voice: 1%

6.Nasal voice: 61%

7.Vocal fatigue: 51%

8.Hoarseness: 1%

9.Indifferen: 70%

10.In audible: 81%

Assess resonance quality, such as normal, hypo nasal, hyper nasal, or cul-de-sac.

1. If abnormal, assess stimulability for normal resonance. 2. If normal, evaluate the focus of resonance, such as (a).oral, (b) pharyngeal, (c) laryngeal, or (d)nasal.

This is very important because puberphonia boys will never try to resonate; it is a learned behavior. Most of them have less activity in the vocal tract.

Measurements of nasalance (vowel /a/, /i/, consonant /m/, oronasal, oral, and nasal texts), nasality degree (Gutzmann test and Bzoch hyper nasality test), voice (acoustic analysis), and articulation (velar sound) were taken before and 3 months after the procedure and compared.

Our voice index: assessment based on observation while a puberphonia boy talks

Laryngeal: overstrain in the neck, 0%

                     - less strain in the neck  88%

Nasal 89%

Oral 11%

Pharyngeal 0%