Treating Presbyphonia in 2024: A Scoping Review

Area of Science:

• Gerontology
• Otolaryngology
• Speech-Language Pathology

Background:

• Presbyphonia, an age-related voice disorder, presents complex multifactorial challenges.
• Effective management necessitates addressing both systemic aging factors and laryngeal dysfunction.
• Geriatric frailty and medication side effects can exacerbate vocal changes.

Purpose of the Study:

• To outline a comprehensive, evidence-based treatment strategy for presbyphonia.
• To propose a tiered therapeutic approach prioritizing non-invasive interventions.
• To identify optimal interventions for glottal gap closure and vocal fold pliability.

Main Methods:

• A literature scoping review was conducted to synthesize current evidence on presbyphonia management.
• The review focused on identifying effective voice therapies and minimally invasive laryngeal procedures.
• Treatment recommendations were formulated based on patient vocal demands and severity of glottal gap.

Main Results:

• Voice therapy, incorporating diverse exercises, is proposed as the primary treatment to enhance voice quality.
• Office-based medialization with hyaluronic acid injection is recommended as a first-line intervention for significant glottal gaps or high vocal demands.
• Platelet-rich plasma injections may complement medialization to improve mucosal vibratory function.

Conclusions:

• A holistic management strategy combining global health optimization and targeted laryngeal therapies is crucial for presbyphonia.
• A stepwise approach, starting with voice therapy and progressing to office-based medialization, offers a tailored treatment pathway.
• Minimally invasive procedures like hyaluronic acid and PRP injections provide effective options for improving vocal function in presbyphonia.