Oral & pharyngeal cavity are voice box

The pitch of the sound and the pitch of the voice are different. Sound is produced by the vocal fold and voice is produced by the Oropharyngeal facilitation.This consideration is of the greatest im-portance in low pitched voice production in puberphonia, as it devolves upon the speaking voice the task of determining the pitch.

Oropharyngeal facilities pitch

Based on the trans-mission of the vibrations of the vocal cords pitch is determined, that UMAR suggest that the pitch is also determined by the vibrations of the resonance chambers which are set in vibration by the sound.

Dr M Kumaresan' 9841055774

Voice in classical language

Vocal fold, epiglottis, uvula, tongue and lips can vibrate to produce sound energy. Going back to the origin of the word Voice, in its root it means speech (voc, in old Sanskrit, "to say”: Vox, in Latin, "to speak"); and has been associated, since its origin, with the qualification of a sound uttered by the mouth in the form of speech or song. The real essence, therefore, of the physical product of the vocal apparatus-the voice as speech was established since the birth of civilization by means of the old classic languages.

Dr siva

Oro pharyngeal facilitation, Procedure by Dr M Kumaresan in puberphonia treatment:

Ask the patient to relax the jaw, tongue, and neck.

Begin with gentle humming, such as /  ஆ mʌ or other comfortable syllables.

Encourage an easy transition from humming to speech.

Avoid excessive laryngeal constriction or deliberate throat tightening.

The voice should come from the throat.

Relax larynx and activate pharynx.

Puberphonia treatment is converting laryngeal voice to pharyngeal voice

  Puberphonia treatment primarily involves shifting from a high-pitched laryngeal phonation (using tense true vocal cords in the larynx) to a normal modal male voice, or in specialized methods like Uvula Manipulation and Resonance (UMAR), utilizing pharyngeal phonation where the pharyngeal walls, soft palate, and uvular region contribute to lower, stable resonance.

Laryngeal vs. Pharyngeal Phonation

• Laryngeal Phonation (Standard Voice The

• How treatment works: Speech-language pathologists use techniques like manual laryngeal depression (gently pushing down on the thyroid cartilage/Adam's apple), coughing, humming, or Y-sigh exercises to drop the larynx and relax the vocal cords.

• Pharyngeal Phonation (e.g., UMAR Method):

• Primary structures: Pharyngeal walls, soft palate, and uvula.

Specialized approaches like Uvula Manipulation and Resonance (UMAR) shift resonance and acoustic coupling away from tight laryngeal tension toward the pharynx to achieve a deep, natural male pitch.

• Voice Therapy (First-Line Treatment):

• Non-surgical and usually curative within days to a few weeks.

• Involves pitch correction exercises, diaphragmatic breathing, vegetative vocalisations (coughing, throat-clearing, laughing to trigger the modal register), and laryngeal repositioning.

• Surgical Options (Rare Cases):

• Considered only if voice therapy fails.

• Procedures like Ishak Type 3 Thyroplasty or UMAR interventions physically alter or relax the laryngeal uvular framework to permanently low pitched voice.

Puberphonia treatment

pharyngeal voice is a standard treatment technique for puberphonia in UMAR.1)

Establish a comfortable lower pitch: Use gentle humming or resonant voice exercises. 2)A gentle snoring followed by sustained vowel production, when clinically appropriate.3)Reduce excessive laryngeal tension.

AI puberphonia

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Dr M Kumaresan

VR for longuiity

Dear Dr & Mr,  sir, We are planning to start "Voice Spa" on Saturday 7th November 2026 at 4pm in Siva ENT hospital Royapettai, Chennai 14. Along with that we are planning to start a free medical library, free hearing, physio with health for longevity of life & voice assessment with free voice,  and  hearing preservation programs class for adults with VR training for Autism, voice, dementia, Parkinson's and other neurological problem.

Waiting for your reply.

- Dr. M. Kumaresan MS ENT

Dr M Kumaresan' s manual

Dr M Kumaresan's kinaesthetic/proprioceptive movement in puberphonia conditioned reflex treatment.

Once the target voice is obtained by pharyngeal voice, pair it consistently with the same kinaesthetic/proprioceptive movement by placing the hand lower abdominal starting position → upward hand movement → target phonation → target resonance/voice → stabilization cabove the head.

In Siva ENT Surgeon puberphonia treatment in a permanent voice.

The voice becomes an established permanent motor behaviour after puberphonia therapy in Siva ENT hospital 

The most important experiment. So there is no recurrences.

Dr M Kumaresan 9841055774

Hand movement -a conditioned reflex for puberphonia

“Air is moved from the stomach into the mouth and sinuses.”

The hand movement may  pairing of this sensory-motor cue with the desired voice may facilitate habituation and eventual automatic use of the lower-pitched voice during connected speech.”Resonance"

The voiced sound generated by the vocal folds is shaped by the pharyngeal, oral and nasal vocal tract.  clinical concept

The hand movement as a conditioned reflex

Dr M Kumaresan' s conditioned reflex.

Initially:

hand movement + respiratory preparation + low-pitch phonation + resonance

are deliberately paired repeatedly.

The hand movement may  pairing of this sensory-motor cue with the desired voice may facilitate habituation and eventual automatic use of the lower-pitched voice during connected speech.”

That formulation is scientifically safer than sayi “air is moved from the stomach into the mouth and sinuses.”

 "Hand-movement → conditioned reflex.

Puberphonia Research

This is particularly important for Dr M Kumaresan's proposed uvular mechanism to treat puberphonia.

It need coustic recording

Measure fundamental frequency (F0), harmonics, formants, intensity and spectral characteristics and recording the same sustained vowel and standardized sentences before and after treatment.

Electroglottography (EGG)

This is especially important.

It provides an independent indication of vocal-fold contact/vibration.

Those who are interesed in doing this research can join with Dr M Kumaresan's 9841055774.

Voice Faraingea

Voce Faringea (Pharyngeal Voice). A historical vocal mechanism used extensively by 18th and 19th-century bel canto opera tenors.

 It modifies the traditional falsetto (which usually sounds thin or breathy) by narrowing the pharyngeal tract and altering vocal cord coordination. This transforms it into a powerful, resonant, and full-bodied sound capable of reaching exceptionally high tenor notes.

We follow the same technology in treating puberphonia.

Dr M Kumaresan 9841055774

voice paringea we follow in treating puberphonia

Voce Faringea (Pharyngeal Voice). A historical vocal mechanism used extensively by 18th and 19th-century bel canto opera tenors.

 It modifies the traditional falsetto (which usually sounds thin or breathy) by narrowing the pharyngeal tract and altering vocal cord coordination. This transforms it into a powerful, resonant, and full-bodied sound capable of reaching exceptionally high tenor notes.

We follow the same technology in treating puberphonia.

Dr M Kumaresan 9841055774

Puberphonia treatment goes to WHO

There is a potentially strong pathway to present our puberphonia work to WHO, particularly if we frame it as an evidence-based health innovation that draws on Tamil linguistic/phonetic knowledge.

Tamil scholars join and cotribute: Dr M Kumaresan 9841055774

Kumaresan treatment method for puberphonia treatment

Kumaresan oropharyngeal facilitation technique 

(KOFT)

Volume 18 Issue 2 - April 10, 2026, Published in ENT International Journal :

Uvula Manipulation and Resonance (UMAR) is a technique designed to oropharyngeal 

facilitation in phonation from the larynx to the pharynx to facilitate pitch lowering in puberphonia.

This was applied in 1,750 individuals diagnosed with 

puberphonia. 

Puberphonia treatment in Siva

Siva ENT Head & Neck Hospital in Chennai, the hospital describes its puberphonia treatment as UMAR (Uvula Manipulation and Resonance), developed by Dr. M. Kumaresan.9841055774.

The larynx and vocal folds are examined, including endoscopic assessment.

The patient is asked to produce sounds such as speech, cough, yawn or snore to identify the lower-pitched voice that can already be produced. It is fixed and habtuated in five days.

Puberphonia treatment

“5 days” “no surgery/no medicine”

"Siva ENT.Com" website. A 2026 Siva ENT post gives the current status, no appointment is required and ENT doctors treat all days except Sundays. Call 9841055774.

The peer-reviewed UMAR paper is important because it provides the published information.

Puberphonia Research in Siva

The comparative acoustic profile below illustrates the typical shifts in key voice parameters before and after voice therapy for puberphonia:

Key Acoustic Parameter Changes

 * Fundamental Frequency (F_0): Drops substantially from an elevated falsetto baseline of around 220 Hz down into the normal adult male modal register (approx. 125 Hz).

 * Jitter (Frequency Perturbation): Decreases significantly from 1.85% to 0.45%, reflecting stable cycle-to-cycle vocal fold vibration as excessive cricothyroid muscle tension is released.

 * Shimmer (Amplitude Perturbation): Improves from 4.2% down to 1.6%, indicating smoother glottal closure and reduced breathiness or acoustic leakage.

 * Cepstral Peak Prominence (CPP): Increases from 5.5 dB to 12.8 dB, representing a much cleaner, more resonant harmonic structure and clearer voice projection.

Puberphonia treatment by conventional reflex

Moving Your Hands from abdomen to heead above creates a conditioned reflex in treating puberphonia.Changes Your Thinking, Boosting Learning and Memory: Moving your hands while learning helps reduce cognitive load, unlocks implicit knowledge, and helps you remember concepts better.

Dr M Kumaresan's UMAR.