Dysphonia in the elderly: diagnosis and management of age-related voice changes

In our laryngology practice, we have noted an increasing number of elderly patients referred to us for problematic dysphonia. We present our findings of the most common disorder affecting this age group. A sample of 47 consecutive patients over age 60 with dysphonia revealed presbylaryngis, ie, age-related anatomic and physiologic changes, as the most common etiology found in this tertiary referral practice, accounting for 30% (14 patients) of new diagnoses. None of the patients with presbylaryngis received this diagnosis from the referral source. Understanding the anatomic and physiologic changes of the aging vocal tract, along with the clinical correlation of each change, is crucial in evaluating this group of patients. Managing this disorder includes specific goal-oriented speech therapy, with surgery as an adjunct should conservative therapy prove unsuccessful. Earlier recognition of this disorder and prompt intervention are key factors in reversing vocal decompensation, with a primary effect of improving the quality of life for the patient with age-related dysphonia.