High Pitched Voice - Causes and Treatment Options

Question: I’m a 19 year old man with a high pitched voice. Is there anything I can do?

Answer:

Thanks for your recent question. I have recently answered a similar question from a 21 year old man with a high pitched voice and have taken the liberty of using much of the answer I wrote to him. Obviously, this is not a rare problem, and can be quite disconcerting to those affected.

Fortunately, most can be helped with a simple outpatient surgical procedure, called  a thyroplasty. There should be people in your area who can do this surgery- or you can certainly contact us at the NY Voice Center of the NY Otolaryngology Group.

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”. 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.

Robert L. Pincus MD