Distribution of Voice Disorders across the Life Cycle

To characterize the distribution of voice complaints and diagnosed voice disorders across the life cycle and to examine age-specific distributions of voice disorders using a large multicenter electronic health record database.

This retrospective descriptive cross-sectional study analyzed aggregate data from Epic Cosmos from March 4, 2023, through March 3, 2026. Patients with coded voice complaints, defined by the SNOMED terms hoarse, chronic hoarseness, and dysphonia, were identified. Age-stratified distribution of voice complaints, any voice disorder, and specific voice disorders was examined across standardized life-cycle groups. Voice disorders included vocal fold Reinke's edema, vocal fold polyp, vocal fold nodule and cyst, vocal fold paralysis, malignant vocal fold disorders, and presbylaryngis.

Among 15,632 patients with voice complaints, the largest proportions were aged 50-64 years (22.9%), 65-74 years (22.6%), and 75-84 years (19.5%), whereas patients younger than 18 years accounted for 4.0% and those younger than 5 years for 1.5%. Among patients with coded voice complaints, diagnosed voice disorders rose across adulthood, peaked in the 50-64-year age group at 14.13%, remained high in the 65-74-year group at 13.91%, and declined thereafter. Vocal fold Reinke's edema clustered in the 50-64-year group (3.46%), vocal fold polyps in the 50-64-year group (4.77%), vocal fold paralysis in the 65-74-year group (9.23%), and malignant vocal fold disorders in the 65-74-year group (1.25%). Voice disorders were more common in males and smokers.

Among patients with coded voice complaints, diagnosed voice disorders demonstrated distinct age distribution with a slight shift to the right. Benign structural lesions clustered in mid-to-late adulthood, whereas vocal fold paralysis and malignant vocal fold disorders predominated in older adults.