Impact of Early Postnatal Androgen Exposure on Voice Development

Background: the impact of early postnatal androgen exposure on female laryngeal tissue may depend on certain characteristics of this exposure. We assessed the impact of the dose, duration, and timing of early androgen exposure on the vocal development of female subjects who had been treated for adrenocortical tumor (ACT) in childhood.Methods: the long-term effects of androgen exposure on the fundamental vocal frequency (F0), vocal pitch, and final height and the presence of virilizing signs were examined in 9 adult (age, 18.4 to 33.5 years) and 10 adolescent (13.6 to 17.8 years) female ACT patients. We also compared the current values with values obtained 0.9 years to 7.4 years after these subjects had undergone ACT surgery, a period during which they had shown normal androgen levels.Results: of the 19 subjects, 17 (89%) had been diagnosed with ACT before 4 years of age, 1 (5%) at 8.16 years, and 1 (5%) at 10.75 years. Androgen exposure (2 to 30 months) was sufficiently strong to cause pubic hair growth in all subjects and clitoromegaly in 74% (14/19) of the subjects, but did not reduce their height from the target value. Although androgen exposure induced a remarkable reduction in F0 (132 Hz) and moderate pitch virilization in 1 subject and partial F0 virilization, resulting in F0 of 165 and 169 Hz, in 2 subjects, the majority had normal F0 ranging from 189 to 245 Hz.Conclusions: Female laryngeal tissue is less sensitive to androgen exposure between birth and adrenarche than during other periods. Differential larynx sensitivity to androgen exposure in childhood and F0 irreversibility in adulthood are age-, concentration-, duration-, and timing-dependent events that may also be affected by exposure to inhibitory or stimulatory hormones. Further studies are required to better characterize each of these factors.

Voice Performance Evaluation of Street Children From Aracaju, Brazil Using Perceptual-Auditory and Acoustic Analyses

Objective. To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses.Methods. A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements.Results. A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. the SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. the maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG.Conclusion. Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.