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Phonosurgery in the elderly: a review.

D H Slavit1

  • 1Ames Vocal Dynamics Laboratory, Lenox Hill Hospital, New York City, USA.

Ear, Nose, & Throat Journal
|August 3, 1999
PubMed
Summary

Aging alters the elderly larynx, affecting vocal fold structure and leading to common voice disorders. Phonosurgical techniques must adapt to these age-related changes for effective treatment.

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Area of Science:

  • Geriatric Otolaryngology
  • Laryngeal Physiology
  • Phonosurgery

Background:

  • Aging causes significant histologic changes in the elderly larynx, including alterations in elastin and collagen fibers, and thinning of mucous membranes.
  • These age-related laryngeal changes contribute to common vocal disorders such as vocal fold atrophy, glottic incompetence, and edema.
  • Understanding these modifications is crucial for managing voice disorders in the elderly population.

Purpose of the Study:

  • To review the age-related structural and functional changes in the elderly larynx.
  • To discuss common vocal fold pathologies and their underlying causes in older adults.
  • To highlight the necessary adaptations in phonosurgical techniques for elderly patients.

Main Methods:

  • Review of literature on geriatric laryngeal anatomy and physiology.
  • Analysis of common vocal fold pathologies in the elderly.
  • Discussion of phonosurgical principles and modifications for aged vocal folds.

Main Results:

  • Key age-related laryngeal changes include alterations in lamina propria composition and mucous membrane atrophy.
  • Common conditions are vocal fold atrophy, sulcus vocalis, glottic incompetence, and vocal fold edema, often linked to reduced lymphatic channels or structural thinning.
  • Phonosurgical procedures for benign lesions and glottic incompetence require careful technique to preserve vocal fold vibratory properties.
  • Histologic changes and altered wound healing necessitate modified phonosurgical approaches in the elderly.

Conclusions:

  • Age-related laryngeal changes necessitate specialized knowledge for effective surgical management.
  • Phonosurgical techniques must be adapted to account for altered vocal fold histology and wound healing in the elderly.
  • Addressing functional voice disorders is as critical as surgical correction for optimal outcomes in geriatric voice patients.

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