Growth promoting treatment normalizes speech frequency in Turner syndrome.
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.


METHODS
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 microg/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.
Andersson-Wallgren
Gunnel
G
Department of Pediatrics, Göteborg Pediatric Growth Research Centre, Institute of Clinical Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
Ohlsson
Ann-Christine
AC
Albertsson-Wikland
Kerstin
K
Barrenäs
Marie-Louise
ML
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000728:Androgens / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D006309:Hearing / Q000502:physiology; D006801:Humans; D007621:Karyotyping; D008875:Middle Aged; D009030:Mosaicism; D013060:Speech / Q000502:physiology*; D011795:Surveys and Questionnaires; D014424:Turner Syndrome / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology*; D014831:Voice / Q000502:physiology
D000728:Androgens; D013006:Growth Hormone