Enriched Thousand Puberphonia/Male talking in female tone patients’ life with ancestral voice by an innovative, non-invasive outpatient treatment in 5 days.
Author
Muthiah Kumaresan 1 Department of Otorhinolaryngology Siva ENT Hospital, 295, Triplicane High road, Triplicane, Chennai, India. 2 Department of OtorhinoLaryngology Saveetha Medical College, Chennai, India. 3. Speech Therapist, Siva ENT Hospital, Chennai, India.
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Abstract:
We followed an innovative, important and relevant method of manipulating the uvula which had given the required low pitch voice in 1000 puberphonia males. 50% of the reported cases had given the history of attempted suicide. The gravity of the problem and the number is so much which is under recognized, less estimated and ignored. We assess the pitch and confirm the diagnosis and no other test is required. We show them the frequency expected to achieve which gives confidence to the patient at the first consultation itself.
How common is puberphonia?
It is stated that it is a rare problem and annually ENT surgeons see one case per year. We simplified our approach, treatment and got more patients, weakly on an average 3 puberphonia.
Inspiration in developing a new treatment for puberphonia
29 years back one boy committed suicide for making fun of his female voice. We continue to get more puberphonia patents. The structure and function of vocal cords are normal in all puberphonia patients. The Hormone level is normal. We tried and tested all types of conventional treatment. Most of them including surgical thyroplasty is a failure in our hands.
One day a mother brought her son, 10 years old, for snoring treatment. Mother told me that the boy is snoring like an adult male pitch. Usually boys will have a childish female voice only. In snoring we used to cut the uvula. From that day onwards we tried various snoring techniques of air flow to treat puberphonia.
Pathophysiology behind our new treatment
We have proved that Puberphonia voice is nasal voice and less powerful. Nasal \ sinus resonance treats puberphonia. When these sounds are produced with resonance in the nasal cavity, sound waves vibrate in the nasal cavity, producing a buzzing vibration in the bridge of your nose that can be felt with the fingertips. How do airplanes move upwards and fly? He explained Bernoulli phenomenon in a simple manner. Without wings the flight can't fly upwards! First create an air flow in front of the aircraft. It is divided upwards and downward by the aircraft wings. The upwards air goes in a funnel shape, because of the slope made in the upper surface of the wings. This makes the pressure above the wings less. On the other hand the air moving to the bottom of the wings is more powerful as the bottom of the aircraft wing is flat. This difference in pressure above and below the aircraft automatically lifts the aircraft.
Similar manners the air that enter the nasal cavity from the pharynx, diverted to the sinuses in a forceful manner by the turbinates and create resonance male voice sound.
Why is a new treatment required?
29 years back we have not taken puberphonia as a serious problem. Parents and doctors ourselves felt this as a hormone problem or as a psychological problem but it is not true. Puberphonia makes their life miserable in mingling with society and marriage because others feel that puberphonia boys are having lady character.
Our Method of treating puberphonia
We employ direct voice therapy. While doing an endoscope to examine the larynx, the patient is asked to say a few words with protrusion of tongue, cough, yarn or snore which give a low pitch voice. This results in the change in the air flow and resonance, which is the physiological mechanism that reduces pitch. The selected case is taken to the minor operation theatre. Under xylocaine (10% w/v) spray surface anaesthesia a silk thread is placed in the uvula by suturing or knots, followed by breath of fire or breath training in the theatre itself by ENT surgeon. In the first instance it-self 90% many resume lower pitch voice. We give group voice breathing training as it is a stimulating factor with their treated colleagues. Third day we removed the thread from the uvula. 4th to 21st day they are instructed to do breath of fire home breathing training to continue low pitch voice as a habit. 5% patients resist changing their voice in spite of the effort we put, even after review, probably, we think, due to some other unknown lifestyle or pathology.
Result
Our experience reveals that puberphonia is not a disease, but it is due to mutated pitch resonance of voice. Our clients are able to overcome blocks and pitch break by their new method of air flow in the phonatory tract by activating uvula. They experience their new desired voice and continue to use it. The treatment is done without any surgery in the vocal tract. Most of the clients get the ancestral voice that makes them and us happy! The important conclusion is uvula is an accessory organ for speech, as uvular trill, uvular consonant is brought out. Uvula manipulated resonance treat puberphonia.
Significant contribution of the person being nominated:
False and myth about puberphonia
There are a number of proposed causes for the development of Puberphonia, that the etiology of puberphonia can be both organic (biological) and psychogenic (psychological) in nature.
1. Hormonal, similarly at puberty, guys’ bodies begin producing excess hormone called testosterone which causes changes in several parts of the body, including the voice. For starters, a guy’s, also known as the voice box, grows bigger. Examination of these patients should include a complete physical examination including a genital examination also. Secondary sexual characters should be assessed; hypogonadism should be ruled out. Genetic origin, Family history of Puberphonia is proposed. We tested testosterone level 100 cases of Puberphonia as a sample study. Their level from 310 to 675ng/dl.
2. It is not due to psychological. As they are left out of society they are considered as indifferent.
3. It is not due to habitual use. They may try all the ways to break the voice. It is concluded that it is not curable.
4. Puberphonia boys are not smart and intelligent. They will have a normal life if they are not disturbed by society.
5. It is not due to anatomical reasons in the vocal tract. They are having normal voices, coughing and yawning.
6. It is not due to neurological. After puberphonia treatment they lead a normal life.
7. Bad parenting is not the cause for developing pubertphonia. Puberphonia is not a disease, it is a life experience.
8. It is easily curable by uvula resonance manipulation. Our study concludes that our treatment for puberphonia by an outpatient treatment by uvula manipulation and breath of fire therapy. Not only does it improve the voice, it also improves the personality of puberphonia clients and we provide thorough further knowledge about puberphonia among the society and health professionals. There are many famous people with puberphonia. We believe that you also have the full right and all the necessary qualities and the potential to transform yourself into a fluent confident and an excellent speaker within a short period. We have already proved it several thousand times. The only thing you need is the link with our treatment to cure puberphonia.
Indian (State wise) and Foreign puberphonia treated clients by the author
1. Tamil Nadu 663
2. Pondicherry 10
3. Andhra Pradesh 72
4. Telangana 23
5. Karnataka 48
6. Kerala 45
7. Punjab 22
8. Madhya Pradesh 34
9. Rajasthan 35
10. Bangladesh 11
11. Nepal 9
12. U.S.A 2
13. Australia 6
14. Srilanka 10
15. Jharkant 10
TOTAL 1000
Number of years working in the field: 29 years.
First puberphonia 11 cases were treated reported in his published book in 1992.
Puberphonia Impact/Outcome in society: by the work done by the person being nominated: puberphonia treatment relieves all these impacts.
An impact of puberphonia in males includes:
1.Physical health
2.Mental health
3.Leads to low confidence, self-doubt, anxiety and depression
4.Anxious avoidance behaviour.
5.Obsessive thoughts about self – image
6.Eating disorders like anorexia and binge eating
7.Delayed or no marriage
8.Live lonely or leave the home
9.Live with friends
10.Suicide tendency
Publications on Puberphonia research by the author:
1. “Tholkappiyam Leads Bernoullies Phenomenon in Voice Production and Maintenance, Kumaresan, M. World Classical Tamil Conference, 5-day Summit | June 2010, Coimbatore.
2. Assess the Impact of Puberphonia in the Society - Science ...article. MuthiahKumaresan,Science publishing group.com › … May, 2019.
3. An immediate and permanent cure for Puberphonia www.researchgate.net › amp.Muthiah Kumaresan Journal of eISSN: 2379-6359, Otolaryngology-ENT Research, Published: July 31, 2018.
4. A study of parallels in the works of Tholkappiyar and Bernoulli, Dr.M.Kumaresan, The 10th World Tamil Conference, Chicago. 4th July 2019.
5. Fast Track Treatment for Puberphonia, Kumaresan M* and Navin Bharath, Published: February 05, 2020. Scholarly Journal of Otolaryngology (SJO).
6.New concept for uvula manipulation to treat Puberphonia, Journal of Otolaryngology-ENT Research, Muthiah Kumaresan; K.Navin Bharath, Volume 12 Issue 3 – 202.
7. Puberphonia Treatment by Uvula Manipulation, Muthiah Kumaresan1* and Navin Bharath2 Received: September 28, 2020, Acta Scientific Otolaryngology . Volume 2 Issue 12 December 2020.
8. Video of one of a puberphonia treated patients. https://youtu.be/ AHaktHeOEk0.
9. Uvula Manipulation and Resonance (UMAR) Treatment for Puberphonia, Indian Journal of Otolaryngology and Head & Neck Surgery,https://link. springer.com/content/pdf/10.1007/s12070-021-02412-3.pdf.
10. Puberphonia; https://www.sorkuvai.com/blog/files/solvayal-dec2021.pdf
11. Puberphonia and its treatment in ancient Tamil literature, LOVE THAMIZH Flower-3, Petel-6, June-2022. Dr.Muthiah Kumaresan, Dr.K.Navin Bharath.
12 ENT Surgeons references: Dr Sudhakar Vaidya Dr G Vyas MP R D Gardi Medical College and Ujjain Charitable Trust Hospital Ujjain MP India and Dr Anjana A Mohite Department of Otolaryngology Head and Neck Surgery Dr D Y Patil University's Medical College Hospital and Research Institute Kolhapur 416006 Maharashtra INDIA had referred Dr M Kumaresans puberphonia research in their articles as a pioneer work
13. INTERNATIONAL CONFERENCE ON OTORHINOLARYNGOLOGY, NOVEMBER 22 232021 DUBAI UNITED ARAB EMIRATES
14. M Kumaresan a guide for BSc MSc M Phil and PhD University Students
Research projects completed in virtual reality training affiliated to Tamilnadu Dr. MGR Medical University
Attachments: Publcations and Books published by the author,
1 .First Edition : 1992 Clinical and Practical Otorhinolaryngology
2. First Publishing date: January 2017 VIRTUAL REALITY IN HEALTH AND DISEASE
3. Edition : October 2018 Puberphonia Treatment a novel approach
4. Edition : January 2019 TEXT BOOK FOR VIRTUAL REALITY SCIENCE
5. Edition : January 2019 Puberphonia
6. Volume 5, No.1-2, 2019: International Journal of Otorhinolaryngology ref to page no.39 Assess the impact of puberphonia in the society
7. Edition : January 2020 PUBERPHONIA RESEARCH
8. Edition : 2022 UMAR FOR PUBERPHONIA
9.பதிப்பு ஆண்டு : 2022 மகரக்கட்டு மருத்துவம் கீச்சுக்குரலுக்கு புதிய எளிய சிகிச்சை
Feedback on puberphonia treatment,
1. Kattesh V. Katti, M.Sc.Ed, PhD, DSC, FRSC, FNAI
Distinguished Curators’ Professor of Radiology and Physics
Margaret Proctor Mulligan Distinguished Chair Professor of Cancer Research
Director, Institute of Green Nanotechnology; Director, University of Missouri Cancer Nanotechnology
Platform, One Hospital Drive, Columbia, Missouri 65212, USA.
It is a good paper. However, in the future, you should publish in high impact journals so that your work gets international recognition. Once we start our collaborations, we will then draft high quality publications in high impact journals.
2. Dr. İsmail İlter Denizoğlu MD. (Creator of Doctor VOX),Otorhinolaryngology, Head&Neck Surgery Department, İzmir Medical Park Hospital, İzmir, Turkey. Dear Dr Kumaresan,.The idea of pulling the uvula and phonate is really impressive, Your patient group is huge, which is probably the biggest in the literature The uvula maneuver is really interesting, I will think about it seriously. I will be happy to cooperate and work together.
3. Dr.Amarendra Vasi Reddy FRCS, Queens Hospital Romford UK. Dear Dr. M.Kumaresan, Very nice, explaining Bernoulli's theory was very good easily understandable for a lay person. Maybe you can consider to give an online talk for half an hour to our Tamil group in UK.
4. Dr.Muhammad Saleem ,FCPS, DLO, MBBS
Head of Department ENT, Head and Neck surgery, Aziz Fatimah Medical and Dental College,
Faisalabad. Specialist in Endoscopic sinus surgery, CSF leak repair, Phono surgery and Rhinoplasty.
Thank you very much for guidance. I got your point and will do the same in future.
5. Dr Maria du Toit,Clinical lecturer, Faculty of Humanities, Room 3-14, Level 3, Communication ,Pathology Building, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
Thank you for also sharing your research and technique with us. We will go and look at the video as well as your publications to further understand how this technique works.
We will keep in contact with you.
Kind regards,
6. B P International, Third Floor, 207 Regent Street, London, W1B 3HH, UK, Fax: +44 20-3031-1429.
Dear Dr.Kumaresan Muthiah, We hereby heartily congratulate you for the publication of your following paper. We appreciate your hard work and sincerity behind the publication of this excellent paper. “An immediate and permanent cure for Puberphonia” in Journal of Otolaryngology-ENT Research Volume 10 Issue 4 – 2018,We’re happy to inform that your paper has been selected to be included as one of the potential book chapters of the following book. ,Book name: New Frontiers in Medicine and Medical Research.
7. Teachers take a break from shouting in class - The Hindu
15-Dec-2012 — Dr. M. Kumaresan, who engaged the teachers at the day-long seminar, began with the very basics — breathing techniques.
Professionals who employ their voice, such as singers, teachers, actors and politicians, must produce sound from the abdomen rather than the throat, Dr.Kumaresan said.
8. New Indian Express
Use your abdomen to speak, says expert
15-Dec-2012 — Dr M Kumaresan, an ENT expert, gave a lecture and demonstration of the various voice care techniques to a large gathering at the Tamil Nadu ...
Dr M Kumaresan, an ENT expert, gave a lecture and demonstration of the various voice care techniques. “The main factor for any voice change is not infection, but use, misuse and abuse of voice,” he added. So, what is the secret behind a good voice? “Instead of using throat muscles, use the abdomen for speaking,” he exhorts.
9. Dr.Sudhakar Vaidya, Dr. G. Vyas(MP), and Dr. Anjana A Mohite
Department of Otolaryngology, Head and Neck Surgery, Dr D Y Patil University’s Medical College Hospital and Research Institute, Kolhapur-416006, Maharashtra, INDIA,
Had referred Dr.M.Kumaresan’s puberphonia research in their articles as a pioneer work.
Details of Other Awards or Honours’ Received by the Nominee/ author.
(a). Highest Award To Dr.M.Kumaresan at NSTL.Visakapatnam
MIRA PAUL MEMORIAL GOLD MEDAL IS PRESENTED TO AN EMINENT ACOUSTICIAN/ ENT SURGEON, IRRESPECTIVE OF NATIONALITY, AGE, OR SOCIETY AFFILATION TO PROMOTE INTERNATIONAL BROTHERHOOD IN THE DIVERSE FIELD OF ACOUSTICS. THIS IS THE HIGHEST AWARD PRESENTED BY INTERNATIONAL RESEARCH INSTITUTE FOR THE DEAF, INDIA TO AN INDIVIDUAL WHOSE DEDICATION AND DEVOTION TO ACOUSTICS ARE UNIVERSALLY ACKNOWLEDGED.
CITATION FOR MUTHIAH KUMARESAN
.... for contributions on Ear, Nose and Throat
NSTL, Visakhapatnam, A.P. * 22 December 2008
Now International Research Institute for the Deaf is running in a floor of Siva ENT Hospital, where research work is carried out. His love for Physics is reflected in his books on medicine and medical profession.
(b) Invited Speaker for the Satellite Symposium at Tokyo in 1983
(c) Preliminary lecture- Aetiology of Otitis Media in the 3rd World at Seoul in 1983
(d) Guide for Zonal Conference award at Mysore in 1984.
(e) Best ENT Surgeon, South Zone ENT Conference of India, Kolar, 1985.
(f) Dr.Kumaresan received national e-mark award in the year1986.
(g) He received Paediatric ENT surgeon award in the year1990.
(h) He also received Santhanammal award in the year 1990.
(i) Gold Medal Paper in First APOI conference in 1994.
(i) He received First Prize for Medical book written in National Language by Tamil Nadu Gevernment 1996 and 1997 for two medical books.
(j) Tamilnadu State Council for Science and Technology presented him Science Popularization award in the year 2002.
(k) Acoustical Foundation for Education and Charitable Trust presented Silver Medal for his outstanding contribution as an ENT surgeon in 2007.
(l) Invited speeker -INTERNATIONAL CONFERENCE ON OTORHINOLARYNGOLOGY, NOVEMBER 22 232021 DUBAI UNITED ARAB EMIRATES
(m) “I am a Innovator” pin presented by American Medical Association in 2022.
Dr.Kumaresan is life Member of (1) Association of ENT(National),(2) Equilibriometric Society (International),(3)Phoniatric Society (International),(4) Logopeedic Society(International), (5)Indian Medical Association ,(6)Indian Rhinology Society, (7) Otoneurology Society (National),(8)Founder Member of Neurotology (National),(9)Founder Member of Association of Paediatric Otolaryngitis of India,(10)International Association of Laryngectomy & Phoniatric (Switzerland),(11)International Chest Physician (UK),(12) Politzer Society (USA) and full member of Acoustical Society of America (USA) Dr. Kumaresan is Fellow of National and International Societies:(13)Indian Council of Science (14)International Voice Association (Hungary),(15)Royal Society of Health (London),(16)Acoustical Foundation for Education and Charitable Trust.
Conclusion
This treatment is a pathway of creating new ideas in treating puberphonia / boys talking in a female tone. Voice of a man resembling a woman, may not be either a disease or a medical deficiency in the common parlor, but considering the effect of such inherent defect causing mental trauma, and making their future, a big question mark, particularly among the younger generation. It has been taken as a challenge and is able to remove such defects, thus silently doing a revolution in the field of Medical Science and has cured nearly 1000 patients, which is a marvelous achievement. The main objectives are awareness, identification, diagnosis, evaluation, data collection, and treatment; follow up and thereby eradication of puberphonia from the society. This topic is new and important to the prospective medical students, residents, specialists, fellow, ENT specialists, and generalists because it is a specific, relevant common condition of an unknown aetiology.
