Editor's Note: This Manuscript was accepted for publication January 16, 2008. This study was funded by grants from the Swedish Research Council (7509), the Swedish Board of Health and Welfare, governmental grants according to LUA/ALF, the Council for Research and Development in Västra Götaland, and an unrestricted research grant from Pharmacia. Pharmacia supplied hormone for the growth hormone trials.
Growth Promoting Treatment Normalizes Speech Frequency in Turner Syndrome†
Version of Record online: 2 JAN 2009
Copyright © 2008 The Triological Society
Volume 118, Issue 6, pages 1125–1130, June 2008
How to Cite
Andersson-Wallgren, G., Ohlsson, A.-C., Albertsson-Wikland, K. and Barrenäs, M.-L. (2008), Growth Promoting Treatment Normalizes Speech Frequency in Turner Syndrome. The Laryngoscope, 118: 1125–1130. doi: 10.1097/MLG.0b013e31816927de
- Issue online: 2 JAN 2009
- Version of Record online: 2 JAN 2009
- Turner genotype;
- hormone replacement therapy;
- growth hormone
Objective: To assess objective and subjective voice parameters among Turner syndrome (TS) women in relation to genotype, hearing, growth, and previous treatment with growth hormone (GH) and androgen given that lowering of speaking fundamental frequency (SFF) during treatment is regarded as a negative side effect.
Study Design: Cross-sectional, controlled for karyotype and age.
Methods: Voice function was studied objectively (SFF) and subjectively (questionnaire) in 117 women with TS.
Results: SFF did not differ between treated and nontreated participants or between patients with a spontaneous versus induced puberty. SFF was dependent on karyotype but not age. Subjective voice change was reported four times more often among treated compared with nontreated TS women (odds ratio [OR] = 4.4; 95% confidence interval [CI]: 0.9–20.10), whereas voice and articulation problems were reported three times more often among untreated compared with treated cases (OR = 2.9; 95% CI: 1.0–8.3). Voice symptoms were over-represented among patients having micrognathia (OR = 6.0; 95% CI: 1.6–22.3), hearing loss (OR = 8.6; 95% CI: 1.7–43.1), and monosomy (OR = 6.2; 95% CI: 0.8–36.2) but not among those with an arched palate.
Conclusions: When given to TS girls, GH (33–66 μg/kg/d) and androgen (0.05 mg/kg/d) normalized SFF and reduced voice and articulation problems in adulthood. The TS phenotype includes important voice and speech problems, which in turn are associated with hearing problems, although genotypic, monosomic, and isochromosome patients have more voice problems and also more high-pitched voices than mosaic patients. Most TS women, despite their karyotype or age, exhibit a higher frequency of pitched voice than non-TS women.