Vocal Fold Atrophy: Where Are We and Where Do We Need to Go? A Systematic Review and Meta-analysis

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Gerontology

Background:

• Presbyphonia, an age-related voice disorder, impacts vocal function and quality of life.
• Effective treatment strategies for presbyphonia are crucial for improving patient outcomes.

Purpose of the Study:

• To systematically review and compare the efficacy of different treatment modalities for presbyphonia.
• To evaluate voice therapy versus augmentation techniques in managing presbyphonia symptoms.

Main Methods:

• A systematic literature search was conducted across PubMed, Ovid MEDLINE, and Embase databases (2013-2023).
• Studies were reviewed based on PRISMA guidelines, extracting data on demographics, interventions, and outcomes.
• Interventions were categorized into voice therapy and augmentation; a random effects model assessed mean differences for VHI-10 and maximum phonation time (MPT).

Main Results:

• Twenty-four publications involving 432 patients (mean age 71.2 years) met inclusion criteria.
• Voice therapy demonstrated a numerically higher effect size for VHI-10 (VT -1.26 vs. Augmentation -1.15) and MPT (VT +1.95 vs. Augmentation +0.73).
• Neither outcome measure showed a statistically significant difference between voice therapy and augmentation (P > 0.05).

Conclusions:

• Voice therapy exhibited a numerically greater effect size than augmentation for presbyphonia, but without statistical significance.
• Current evidence does not establish statistical superiority of one treatment over the other.
• Prospective studies are required to identify optimal treatment algorithms for presbyphonia, considering combined therapies.