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Growth Promoting Treatment Normalizes Speech Frequency in Turner Syndrome
Author(s) -
AnderssonWallgren Gunnel,
Ohlsson AnnChristine,
AlbertssonWikland Kerstin,
Barrenäs MarieLouise
Publication year - 2008
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e31816927de
Subject(s) - confidence interval , turner syndrome , medicine , audiology , odds ratio , isochromosome , testosterone (patch) , karyotype , chromosome , biology , genetics , gene
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.