Question:Hi, I am a 21-year old male from Bangladeshi. I’ve had a problem with the pitch of my voice for at least the past 10 years, and I am quite desperate to get rid of the problem. My voice is quite high-pitched and my voice cracks whenever I try to speak louder. It’s like almost no sound comes out, a few squeaky syllables get out…
My doctor told me it is from a post-nasal drip, but I don’t know the specific details. I feel that the problem gets amplified whenever I’m outside, so it might be dust-induced since our country’s air is quite unclear.
I study in a business school, so I’m having a lot of trouble with this problem. I also get teased a lot for the girlish voice. My parents are against a certain surgery to remove the lump, they consider it impractical.
Please advise me how may I improve my voice on my own. If you need any further information, please ask me. I await your reply.
Answer:
Thank you for your question. As we age our voices change. There is a specific change in a male teenager’s voice as the cartilage of the larynx (voice box) gets thicker around puberty. However, sometimes this does not occur as one would like, leaving the voice with a high pitch. A high pitched voice can be quite a social problem for a young man- just as a low pitched voice can be an issue for a woman in our society.
A high pitched voice is not usually caused by a lump in the throat or a post nasal drip. The problem can be from using one’s voice incorrectly- such as in a falsetto- which should respond to voice therapy. Vocal cord paralysis or vocal cord nodules or polyps can result in a high pitched voice which is also usually breathy. Comprehensive evaluation of these areas by an ear nose and throat physician should readily determine the cause.
However, often a high pitched voice is due to the vocal cords being stretched too tightly by the failure to develop a thickening of the voice box with puberty. If one pictures a string instrument, we raise the pitch by tightening the string and lower it by loosening the string. Groundbreaking work was done by Professor Ishiiki from Japan probably 25 years ago and I had the opportunity to participate in his first teaching course in this country. He developed the idea of “laryngeal framework surgery” also known as pitch lowering surgery. Basically, for a high pitched voice- without other cause- we surgically remove a thin strip of cartilage from the voice box, as an outpatient procedure under local anesthesia. This allows the vocal cord to relax and lowers the pitch of the voice. Its results are immediate and gratifying.
Unfortunately, trying to raise the pitch by tightening the vocal cords has been less successful.
I am not sure who in your area does this type of work, but I would check with the local ENT societies.
Robert L. Pincus MD
Associate Professor Otolaryngology
New York Sinus Center
Frequently Asked Questions
A high-pitched voice in males after puberty can result from the failure of the laryngeal cartilage to thicken as expected during puberty. This causes the vocal cords to be stretched too tightly, producing a higher pitch. Other causes include improper voice usage, vocal cord paralysis, nodules, or polyps, which require medical evaluation.
Post-nasal drip is generally not a direct cause of a high-pitched or cracking voice. While it can cause throat irritation or mucus accumulation, the pitch problems typically stem from vocal cord or laryngeal issues. A thorough examination by an ENT specialist can clarify the cause of voice changes.
Laryngeal framework surgery, also known as pitch lowering surgery, is a procedure where a thin strip of cartilage is removed from the voice box under local anesthesia. This loosens the vocal cords, allowing the voice pitch to lower, producing immediate and satisfying results for individuals with an undesirably high pitch due to incomplete larynx development.
Voice therapy can be effective if the high pitch is due to improper use of the voice, such as speaking in falsetto. However, if the cause is structural or developmental, like vocal cord stiffness from incomplete puberty changes, therapy might have limited benefits. Professional evaluation is essential to determine the best approach.
Voice cracking or squeakiness when speaking loudly often results from vocal cords being stretched too tightly or improper voice technique. This limits airflow, producing weak or broken sounds. Addressing underlying structural issues or improving voice use through therapy can help reduce these symptoms.
Exposure to dust and poor air quality can irritate the throat and respiratory tract, potentially making voice problems worse. While not a primary cause of a high-pitched voice, environmental irritants can exacerbate symptoms like throat discomfort or voice fatigue, so minimizing exposure is beneficial.
If you suspect vocal cord paralysis or nodules due to persistent voice issues like breathy or high-pitched sound, see an ear, nose, and throat (ENT) specialist for a comprehensive evaluation. They can perform necessary examinations to diagnose the problem and recommend appropriate treatment.
