Impact of early postnatal androgen exposure on voice development

Area of Science:

• Endocrinology
• Pediatric Endocrinology
• Vocal Cord Physiology

Background:

• Early postnatal androgen exposure can impact female laryngeal development.
• The specific characteristics of this exposure (dose, duration, timing) are crucial.
• This study investigates these effects in female patients treated for adrenocortical tumor (ACT) in childhood.

Purpose of the Study:

• To assess the long-term effects of early androgen exposure on vocal development in female ACT patients.
• To examine the impact on fundamental vocal frequency (F0), vocal pitch, final height, and virilizing signs.
• To understand the relationship between exposure characteristics and vocal outcomes.

Main Methods:

• Studied 9 adult and 10 adolescent female ACT patients with a history of childhood treatment.
• Evaluated long-term vocal parameters (F0, pitch) and physical development (height, virilizing signs).
• Compared current values with post-surgery data when androgen levels normalized.

Main Results:

• Most subjects (17/19) were diagnosed with ACT before age 4.
• Androgen exposure caused virilizing signs (pubic hair, clitoromegaly) but did not affect final height.
• Vocal effects varied: one subject had significant F0 reduction and pitch virilization, two had partial virilization, but most maintained normal F0 (189-245 Hz).

Conclusions:

• Female laryngeal tissue exhibits differential sensitivity to androgens during childhood.
• Sensitivity is less pronounced between birth and adrenarche compared to other periods.
• Vocal fold changes (F0) are age-, concentration-, duration-, and timing-dependent and may be irreversible in adulthood.