Ultrasound Elastography Detects Age-Related Changes in Adult False Vocal Folds

To investigate the feasibility of ultrasound elastography for assessing the symmetry in stiffness values and movements of both false vocal folds (FVFs).

After Institutional Review Board's approval and written informed consent obtained, we measured ultrasound strain and shear wave velocity (SWV) of the bilateral FVF in vocal fold abduction and adduction in 30 participants using a linear array transducer (4-10 MHz). Twenty-eight participants met inclusion criteria as healthy subjects for analysis. Mean strain of FVF produced by FVF movement from abduction to adduction was analyzed using 2D speckle-tracking software offline. A SWV ratio ([SWV_adduction - SW_abduction ]/SW_abduction ) was developed to test the contractibility of FVF. Statistical analysis included one-way ANOVA to test the difference in mean strain, SWV (adduction and abduction), and SWV ratio among the three age groups; linear regression to analyze correlations of stiffness and movement between the right and left FVF; and intraclass correlation coefficient (ICC) to examine intra- and interobserver reliability in performing shear wave elastography (SWE) of FVF.

The 28 healthy participants were divided into 3 age groups (10 of young 20-44 years; 9 of mid-age 45-64 years; and 9 of senior ≥65 years). The SWV in FVF abduction was higher and the SWV ratio was lower in seniors compared to young participants (P < .05). Good to excellent correlation of mean strain and SWV between both FVFs (R²  > 0.89). The reliability of performing SWE of FVF was moderate to excellent.

Ultrasound elastography is feasible to assess the stiffness, dynamic movement, and symmetry of adult FVF, and healthy seniors may exhibit increased FVF stiffness.