Voice Therapy for a Case of Recalcitrant Mutational Dysphonia

Abstract

A 14-year-old boy presented recalcitrant mutational dysphonia with excessive tension of the muscles of his speech organs. The patient did not respond to any facilitating technique of voice therapy such as coughing, humming or hard glottal attack in producing low-pitched voice. Five sessions of voice therapy, including use of the "Kayser-Gutzmann" method in which the larynx is manually pulled downward before phonation, and tongue relaxation were necessary in order to obtain a normal low-pitched voice. After twelve sessions (four months) of voice therapy, stabilization of the low-pitched voice was accomplished. The fundamental frequency of the voice was lowered from 350 Hz before to 120 Hz after the treatment. At 2-years' follow-up, the normal low-pitched voice was successfully maintained but the patient used a falsetto voice at home.Most cases of mutational dysphonia respond well to voice therapy alone, and can easily achieve a complete and permanent low-pitched voice within several sessions of voice therapy. In some patients with recalcitrant mutational dysphonia, however, relatively long-term (4 to 東北文化学園大学医療福祉学部リハビリテーション学科 1）