Synonym for [intlink id=”323″ type=”post”]lowered vocal ceiling[/intlink]. This is a type of vocal phenomenology most often seen in the [intlink id=”422″ type=”post”]perimenopausal voice[/intlink]. It may also be seen in cases of [intlink id=”544″ type=”post”]superior laryngeal nerve paralysis[/intlink], or cricothyroid joint [intlink id=”37″ type=”post”]ankylosis[/intlink]. The individual with this problem may note that he or she cannot access a part of the upper voice, be that a few notes or an octave or more. As the individual approaches the ceiling of the voice, whether normal or lowered, one begins to hear muscular effort, and often a tendency for the pitch to flat against the person’s will.