User:SarahJay/sandbox

The following are some of my ideas on how to contribute the wikipedia article Puberphonia.

Puberphonia
While reading through the current article on Puberphonia, I noticed some areas that needed to be updated or modified, and thought of some sections that could be added in order to make the article more complete. Firstly, I feel that the introduction and definition sections are too general and don't seem to flow logically. For example, the introduction doesn't provide any specific information on puberphonia; rather, it gives a short overview on the development of the Adam's Apple. I believe that the article will start off stronger if the introduction is more directly related to puberphonia, while the definition section could consist of some of the information from the original introduction section. Secondly, there are some grammatical errors throughout the article that need to be addressed as well as some syntactic structures that could be simplified.

In addition to these changes, I feel that the current causes and treatment sections are limited. I hope to add a more updated list of causes, referencing current literature. I also plan to describe some of the treatments in more detail. A section on prevalence, including specific numbers of diagnosed cases cross culturally could be interesting as well.

Causes
There are a number of proposed causes for the development of puberphonia. Research has shown that the aetiology of puberphonia can be both organic (biological) or psychogenic (psychological) in nature. In males, however, organic causes are quite rare and psychogenic causes are much more common.

Psychogenic causes of Puberphonia include: Organic causes of Puberphonia include:
 * Emotional stress
 * Delayed development of secondary sex characteristics
 * Self-consciousness resulting from an early breaking of the voice
 * Hero worship of an elder male or sibling
 * Excessive maternal protection
 * Laryngeal muscle tension which then causes laryngeal elevation
 * Muscle Incoordination
 * Congenital anomalies of the larynx
 * Vocal fold asymmetries
 * Unilateral vocal fold paralysis
 * Non fusion of the thyroid laminae. When this is the case, it is important that hypogonadism is ruled out, as this may be the cause.

Treatments
Audiovisual feedback:

In puberphonia, the use of audiovisual feedback allows the patient to observe graphic and numerical representations of their voice and pitch. This allows the patient to determine an ideal pitch range based on normative data on age and gender, and incrementally work through speech tasks while working in that desired pitch range. As the patient improves, speech tasks progress to become more natural, involving tasks such as reciting automatic information, to reading, to spontaneous speech and conversation. Incorporating audiovisual feedback in speech and voice therapies has proven successful in intervention, by improving motivation and guidance.

Surgery:

In some cases when traditional voice therapy is ineffective, surgical interventions are considered. This can occur in situations where intervention is delayed or the patient is in denial, causing the condition to become resistant to voice therapy.

There are different types of surgical interventions, which have proved successful in lowering the vocal pitch in men with puberphonia who had previously received ineffective voice and psychotherapy. The first surgical intervention developed, called Relaxation Thyroplasty or Retrusion Thyroplasty, involves a bilateral excision of 2 to 3 mm vertical strips of thyroid cartilage, lowering the vocal pitch through anteroposterior relaxation and shortening of the vocal folds. It can be performed under local or general anesthesia.

Relaxation Thyroplasty by a medial approach is a modified approach of traditional Relaxation Thyroplasty. This version involves lowering the vocal pitch by creating an incision bilaterally in the thyroid lamina and then depressing the anterior segment of the thyroid cartilage.

A more recent, less invasive intervention is the Window Relaxation Thyroplasty. This approach involves creating a window at the anterior commissure which is then displaced posteriorly.

Potential Bibliography
Puberphonia: A novel approach to treatment SarahJay (talk) 01:15, 26 September 2017 (UTC)

Voice Outcome Measures in Puberphonia SarahJay (talk) 17:43, 28 September 2017 (UTC)

Also, we can use this powerpoint source to access other cited sources.... Gives examples of different studies. SarahJay (talk) 17:49, 28 September 2017 (UTC)