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Background People with cluster headache (CH) are frequently burdened by misdiagnosis or diagnostic delay. The peculiar somatic and behavioral changes characterizing patients with CH are not useful to improve diagnostic accuracy. In our clinical experience, we noticed a typical voice quality with low and croaking tone in patients with CH. In this cross‐sectional study, we evaluated, by digital voice analysis, whether it is possible to identify typical voice quality characterizing patients with CH compared with healthy controls (HCs). Furthermore, to investigate whether putative differences in voice characteristics could be underpinned by constitutional aspects or pathological processes of vocal cords, subjects underwent a videolaryngostroboscopy. Smoking habits and alcohol consumption were specifically investigated. Methods After conducting digital recording of the voices from both patients with CH and HCs in a soundproof insulated cabin in the laboratory of the Audiology Department, a set of voice parameters was analyzed. We included the measures of fundamental frequency, calculations of jitter and shimmer, and noise‐to‐harmonics ratios as well as quantities related to the spectral tilt (i.e., H1–H2, H1–A1, H1–A2, and H1–A3) in 20 patients with CH and in 13 HCs. A videolaryngostroboscopy was performed in all subjects. Results Patients with CH, explored during the cluster bout period, showed significantly lower second harmonic (H1–H2) values compared with HCs (−6.9 ± 7.6 vs. 2.1 ± 6.7, p = 0.002), usually characterizing the so‐called creaky voice. By using a laryngoscopy investigation, a significantly higher prevalence of mild to moderate vocal cord edema and laryngopharyngeal reflux signs were found in patients with CH (100% of patients with CH vs. 15% of HC, p < 0.001). Conclusion Creaky phonation is a “physiological mode of laryngeal operation” usually underpinned by shortened and thickened vocal folds. Creaky voice phonation can be due to a vocal fold's reduced capability to become slack or flaccid secondary to vocal cord edema underpinned by laryngopharyngeal reflux affecting the phonatory mechanisms in patients with CH. The laryngopharyngeal reflux may represent a dysautonomic sign related to the increased parasympathetic tone during in‐bout period, reinforcing the hypothesis of an extracranial autonomic dysfunction as part of CH clinical picture.

Summary This contribution is dedicated to William Dwight Whitney (1827–1897), a scholar who generally has a modest space dedicated to him in the historiography of linguistics, despite his name and works having had considerable circulation among his contemporaries. His originality and method are outlined with particular attention being given to his reception in Europe and in the setting of Italian studies of theoretical and empirical linguistics. Whitney was among the first to contest Schleicher’s concept of language as a natural fact, claiming, instead, that it has social nature, as an ‘institution’ created by man; he was a forerunner in recognizing the relevance of signs and their value, and of language acquisition. In his demonstrations and in his methods he proposes a science of historical linguistics but at the same time it is open to 20th century linguistics and the concept of language as a complex system ordered and crossed by relationships. Both his unique approach to the study of Sanskrit, which emphasised the study of its use and its variants, and his interest for modern languages, makes him a particularly interesting scholar, as he and his reception testify the rise, in Europe and especially in Italy, of a new approach to linguistic issues, no longer exclusively historical-comparative, but also theoretical and general. Nonetheless, Whitney ought to occupy a prominent place in the history of linguistics, because he was also the author of one of the first introductory texts of the discipline, which was published in 1875; in that same year a French translation came out, which was soon followed by an Italian, and a German translation (both 1876).The number of almost contemporaneous translations gives an idea of the gap which a general and introductory work like Whitney’s filled and illustrates that there was a clear need for it. In several works, including recent ones, De Mauro identified the specific characteristics of Italian linguistic studies: we can find a good many of these traits in Whitney as well. Although the fruitful contribution of Whitney’s ideas in an environment which is ‘naturally’ inclined towards the themes and methods the American linguist dealt with, i.e., the ‘Italian linguistic school’, has not been fully recognised until now, it is undeniable that his ideas provided an important stimulus for new interpretations and new models.