Abnormal laryngeal vocal quality in ectodermal dysplasia.

Breathy vocal quality was verified in five of nine patients with the ectrodactyly--ectodermal dysplasia--cleft palate syndrome, nine of 15 patients with either suspected or confirmed anhidrotic ectodermal dysplasia (one case of partial expression), and one of two siblings with the Rapp-Hodgkin form of ectodermal dysplasia. Indirect laryngoscopy in eight of the breathy patients failed to show phonatory glottal chinks or any overt laryngeal pathologic conditions, but it did indicate absence of a normal mucosal covering of the folds. Limited spectrographic studies disclosed widely spaced voicing striations and also suggested prolonged voice onset times. Patients who exhibit breathy vocal quality in the presence of one of these ectodermal dysplasias should be counseled with regard to the advisability of longitudinal care and the avoidance of habitual use of increased vocal effort level.