Complementary & Alternative Medicine

When the voice doesn't match the sex

Complementary & Alternative Medicine
There are males with women’s voice, and females with man’s voice. This does not happen to just a few people. The difference between a man and a woman’s voices is distinguished by the tone which is determined by the vocal fold. Men are lower-pitched than women because they have larger and longer vocal folds. It works the same way in an instrument. Instruments with longer and thicker strings have lower sounds. Hz(hertz) is the unit of measuring the pitch of a sound. The fundamental frequency in a males measures 100~150 Hz, and 200~250Hz in females.

Voice feminization can be achieved by shortening the vocal folds and increasing the voice frequency. The surgery is quite simple, actually. Using very thin equipment, the surface of the upper side of the vocal folds – the mucous membrane – is removed and then the vocal folds are tied together. As the surfaces of the vocal folds are healed and attached, the length of the vocal folds becomes short.

By shortening the length of the vocal folds, the voice tone of a male eventually becomes higher. This method was introduced by Dr. Hyung-Tae Kim, director of Yeson Voice Center, for the first time in the world and its effectiveness and safety have been proved at the Voice Foundation’s Annual Symposium which was held in Philadelphia, U.S.

This voice surgery can help people with androgenital syndrome, an abnormal secretion of hormone in children of masculinization of women, caused by the side effects of hormone therapy for aplastic anemia. Based on the principle that one can change the length of the vocal fold as desired, hoarse or weakened voices due to aging can be recovered. Your vocal folds become wrinkled and thinned just like your skin. However, pulling the vocal folds and tightening them can permanently bring your voice back to youth.

After the surgery, you should not use immoderate voice for 2 months in order for the scars to heal. Also, through the 4-week therapy and rehabilitation program, you will learn how to make sounds properly with the reduced vocal folds and have better results of voice feminization.

In cases when a male is high-pitched like a female, the procedure is relatively simple. Injecting Botox into the vocal fold muscle can increase the tone of voice, and paralyzing the muscle can prevent the production of high-pitched sounds.

Another way to make small vocal folds bigger is to insert the instrument into the vocal fold muscle using percutaneous injection laryngoplasty. The frequency may go down by 70 Hz. Neither of the two methods requires general anesthesia or thyroplasty. However, Botox injection is not permanent, and injections are required every 3~6 months.

We are living in an age of communication. However, there are warning signs ahead for our voice, the most important factor in communication. The increasing number of thyroid diseases and lung cancer, and vocal fold paralysis is causing speaking disorders in humans.

Vocal fold paralysis is an obstinate disorder which causes serious voice changes that hinder the communication. Vocal fold paralysis may be caused by an injury, trauma, or operations of various kinds. In this case, even cancer can be treated and it is not life threatening, its aftereffect, voice disorder, will disturb your social life and lower your quality of life.

Voice is produced when the two vocal folds come together and vibrate. In vocal fold paralysis, the vocal folds do not contact and make a hoarse voice that even the other side is impossible to catch. Someone who has vocal fold paralysis appeals discomfort that they are almost disabled due to the difficulty in conversation and often choking because food and drink slip into the lungs. If you let the food slip into the lungs, it may develop into pneumonia, cause depression of lung activity or other complications.

The causes are various, but mostly paralysis can result from the symptom of cancer or other diseases on the geal nerve track which controls the vocal folds and runs the brain, thyroid, lungs, larynx, heart, cervical vertebral and so on. It is usually a symptom of thyroid cancer, lung cancer or larynx cancer. However, if your voice changed after a trauma, you should hold a doubt about having vocal fold paralysis.

Vocal fold paralysis can disturb your social life and make you want to avoid a meeting or conversation. At a VHI(Voice Handicap Index) research held at Yeson Voice Center in 408 vocal fold paralysis patients, 94.1%(384 persons) of the patients said “People have difficulty understanding what I say,” and 86.5%(353 persons) felt their social activities are restricted because of their voice. 70.6%(288 persons) answered “I feel ashamed of my voice”, “I try to avoid the meeting people because of my voice” and 55.9%(228 persons) said their voices have caused a decrease of income.

Now, it is no longer hard to treat vocal fold paralysis. It can be treated with a simple shot. Injecting a biocompatible material such as Calcium hydroxylapatite into the paralyzed vocal fold to increase the volume could help the vocal folds to make closer contact. It is a simple operation which only takes 15~30minutes, and requires no general anesthesia or hospitalization.

Also, the recovery is so fast that you can eat right after the operation. Some patients might feel uncomfortable in the throat or bring up phlegm for a short while and disappear in the few weeks, without causing difficulty in the daily activities.

It usually recovers with only one operation. If left for too long, it becomes harder to treat because the atrophied vocal folds muscles are just like unused body muscles. Severe vocal fold muscle atrophy may require additional operations. Therefore if you notice sudden changes in your voice lasting more than 2 weeks, you should consult an otolaryngologist for detailed examination and proper treatment.

Yeson Voice Center
The Institute of Performing Art Medicine
#638-13 /Ssangbong Bldg. 2nd fl., Shinsadong, Gangnamgu, Seoul, 135-896, South Korea
Tel: 82-2-3444-0550 / Fax: 82-2-3443-2621
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