Summary
Purpose
To determine if recognition of presbylarynx is easy and straightforward.
Method
First, a systematic review regarding the structural features of the geriatric larynx
through laryngostroboscopy was performed, and its results were presented to the raters
in an educational session. Then, video recordings of rigid laryngostroboscopies were
randomly selected and presented to a panel of otorhinolaryngologists. Intra- and inter-rater
reliability were determined.
Results
Based on the main findings of the systematic review, raters were invited to consider
the diagnosis of presbylarynx when one or more of the following endoscopic signs were
present: atrophic vocal folds (VF), VF bowing, prominence of vocal processes, or spindle-shaped
glottal gap. Twenty otorhinolaryngologists from five tertiary hospitals participated
in this study (residents and specialists). Among 300 evaluations performed (15 video
recordings x 20 raters), the intra-rater agreement was 93.0%. The Cohen´s Kappa for
intra-rater reliability was higher than 0.600 for all the raters except for two residents.
Cohen´s Kappa was higher among specialists (0.893) than among residents (0.826). The
highest Cohen´s Kappa was registered for evaluations performed by specialists with
differentiation in laryngology (0.933). Presbylarynx was identified mostly in laryngostroboscopic
recordings of subjects older than 65 years.
Conclusion
we consider the answer to “Presbylarynx: How easy is it to recognize the aging signs”
to be “After education on signs of presbylarynx, it is easy.” This answer is supported
by the high rate of intra- and inter-rater agreement, in a blinded and randomized
presentation of laryngostroboscopic recordings, and by the fact that the diagnosis
of presbylarynx was mostly attributed to videos regarding subjects aged 65 years and
older. It proves that is not difficult to recognize aging signs in the larynx. Thus,
in the future, more education regarding presbylarynx and further studies to improve
criteria for its diagnosis may improve the management of the aging voice.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of VoiceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Clinical assessment of glottal insufficiency in age-related dysphonia.J voice. 2017; 128: 1-5
- Vocal fold atrophy in a Japanese tertiary medical institute: status quo of the most aged country.J Voice. 2014; 28: 231-236
- Clinical analysis of presbylarynx-vocal fold atrophy in the elderly individuals.Auris Nasus Larynx. 2010; 37: 461-467
- Cause of hoarseness in elderly patients.Otolaryngol Head Neck Surg. 1998; 118: 481-485
- Presbyphonia: a review.Curr Opin Otolaryngol Head Neck Surg. 2007; 15: 137-140
- Vocal characteristics of elderly women engaged in aerobics in private institutions of salvador, Bahia.J Voice. 2016; 30: 9-19
- Voice and ageing: clinical, endoscopic and acoustic investigation.Clin Otolaryngol. 2017; 42: 330-335
- Glottic characteristics and voice complaint in the elderly.J Voice. 2005; 19: 84-94
- Presbylarynx: stratifying endoscopic signs for future researches.Eur Arch Otorhinolaryngol. 2021; 278: 2157-2158https://doi.org/10.1007/s00405-021-06735-3
- The aging voice: a systematic review of presbyphonia.Eur Geriatr Med. 2018; 9: 559-570https://doi.org/10.1007/s41999-018-0095-6
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.BMJ. 2009; 339 (Published 2009 Jul 21): b2535https://doi.org/10.1136/bmj.b2535
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- Quantitative analysis of videostroboscopic images in presbylarynges.Laryngoscope. 2001; 102: 139-144
- Presbylarynx: does body muscle mass correlate with vocal atrophy? A prospective case control study.Laryngoscope. 2021; 131: E226-E230https://doi.org/10.1002/lary.28685
- Presbylarynx: is it a sign of the health status of the elderly? [published online ahead of print, 2021 Jan 16].J Voice. 2021; (S0892-1997(21)00007-2)https://doi.org/10.1016/j.jvoice.2020.12.034
- Some aspects of vocal fold bowing.Ann Otol Rhinol Laryngol. 1994; 103: 357-362
- Causes of dysphonia in patients above 60 years old.Bogaz Ihtis Derg. 2003; 11: 139-143
- The interrater reliability of stroboscopy evaluations.J Voice. 2012; 26https://doi.org/10.1016/j.jvoice.2011.09.009
- Rater methodology for stroboscopy: a systematic review.J Voice. 2015; 29: 101-108https://doi.org/10.1016/j.jvoice.2014.06.014
Article info
Publication history
Published online: May 29, 2022
Accepted:
April 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
