Optimization of an integrated approach to voice correction for endocrinopathies (analytical review)

Dysphonia is a symptom of many endocrine pathologies. Hoarseness, voice fatigue, decrease of the voice pitch, reduce of the range are typical complaints for hypothyroidism, caused by an increased amount of polysaccharides and accumulation of fluid in the lamina propria of the vocal folds. An excess of growth hormone causes an overproduction of insulin-like growth factor-1, which leads to abnormalities in the craniofacial region and proliferation of the upper respiratory tract tissues, including thickening of the laryngeal cartilages, vocal folds and decreasing of the voice pitch. Hyperglycemia, changes in the balance of fluid and electrolytes in diabetes mellitus can indirectly affect the voice: xerostomia complicates phonation due to impaired hydration of the laryngeal mucosa, diabetic neuropathy often disrupts the work of the laryngeal muscles involved in voice formation. Voice changes are observed not only in endocrine disorders, but also during puberty, the phases of the menstrual cycle and during menopause. Laryngeal structures are modified under the influence of hormones and external factors, which generally changes pitch and intensity of the voice, timbre and resonance, articulation and prosodic characteristics. The purpose of this review is to summarize and systematize data on physiological and pathological voice changes in patients of different age groups and sex. The possibilities of a multidisciplinary approach to rational voice correction are demonstrated.