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Presbylaryngis

a state-of-the-art review

Mallick, Ali Sameer; Garas, George; McGlashan, Julian

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2019 - Volume 27 - Issue 3 - p 168–177
doi: 10.1097/MOO.0000000000000540
SPEECH THERAPY AND REHABILITATION: Edited by H. Fiona Robinson and Jo Patterson
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Purpose of review Presbylaryngis is the term used to describe changes in the larynx with ageing. It represents an increasingly common complaint as global populations continue to grow and get older. Presbylaryngis has a significantly negative impact on patients’ quality of life and their ability to participate in society. This article will review the relevant literature on the incidence, pathophysiology, clinical evaluation, and treatment modalities for presbylaryngis.

Recent findings The recently developed Ageing Voice Index (AVI) constitutes the first validated instrument for voice complaints specifically for the elderly. The evidence suggests that the bedrock of treating presbylaryngis centres on voice therapy. Thus, voice therapy should represent the primary treatment offered with surgery reserved for those failing to adequately respond. However, the comparative effectiveness of the different surgical interventions, namely injection laryngoplasty and thyroplasty, remains undetermined highlighting the need for larger, prospective, comparative studies.

Summary Presbylaryngis is characterized by specific changes at the microscopic level resulting in age-related vocal fold atrophy. However, its presence alone does not always result in symptomatic dysphonia and equally, presbyphonia is often multifactorial involving the lower respiratory tract in addition to the larynx. Thus, the role of a multidisciplinary voice clinic for presbylaryngis cannot be overstated.

Department of Otorhinolaryngology – Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom

Correspondence to Julian McGlashan, MBBS, FRCS (Otol), FRCSLT (Hon), Department of Otorhinolaryngology – Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Queens Medical Centre Campus, Nottingham, United Kingdom. Tel: +44 7713093368; e-mail: julian.mcglashan@nottingham.ac.uk

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