Summary
Objective
The primary objective of this study was to assess the prevalence of presbylarynx and
its associated features in an elderly population representative of patients seen in
a tertiary care laryngology practice. The secondary objective of this study was to
compare laryngeal electromyography (LEMG) findings, coexisting VF conditions, medical
history, surgical history, medication use, and other parameters between patients with
and without presbylarynx.
Methods
Adult voice patients aged 60 years and older who underwent strobovideolaryngoscopy
were included in the study. Patients were assigned to one of two groups based on the
majority (≥2/3) agreement of three blinded authors’ (GA, KL, and HP) graded examinations
of strobovideolaryngoscopy (SVL) videos for findings consistent with presbylarynx
(atrophic vocal folds [VFA], vocal fold bowing [VFB], vocal process prominence [VPP]
and anterior glottic insufficiency [GI]). Patient demographics, medical history, surgical
history, medication use, laboratory results, and SVL videos were compiled. Statistical
analysis was performed using SPSS 28.0.0.0 (IBM, Armonk, NY). All tests were performed
two-tailed, and a P-value of less than 0.05 was considered statistically significant.
Results
One hundred sixty-four patients (84 female/80 male, mean age of 68.397 ± 4.947 years)
were included in this study. The prevalence of presbylarynx was 52.4% (n = 86) in
the study population. The mean age of patients in the presbylarynx group was significantly
higher than the nonpresbylarynx group. Additionally, there were significantly more
males than females in the presbylarynx group. The presbylarynx group also was found
to have a higher proportion of ACE inhibitor (ACEi) use. Further, laboratory results
revealed a significantly higher proportion of patients with elevated thyroid stimulating
hormone (TSH) levels in the presbylarynx group. Conversely, patients in the nonpresbylarynx
group were found to have a significantly higher rate of levothyroxine use. On SVL,
patients in the nonpresbylarynx cohort were found to have a significantly higher proportion
of benign vocal fold lesions and vocal fold paresis. However, LEMG testing revealed
no statistically significant differences in muscle recruitment between groups. Men
with presbylarynx were found to have a significantly higher proportion of VFB and
VPP compared to women with presbylarynx.
Conclusion
This retrospective study investigated the prevalence and risk factors associated with
presbylarynx in patients representative of those treated by laryngologists. Signs
consistent with presbylarynx are observable even in the presence of coexisting VF
conditions. Older age, elevated TSH, the use of ACEi, and male gender was associated
with signs of presbylarynx on SVL. Of those diagnosed with presbylarynx, males were
identified as having higher proportions of VFB and VPP compared to females. More education
regarding presbylarynx and further studies to improve standardization of the criteria
for its diagnosis, as well as its relationship with other VF conditions, are encouraged
to improve management of the aging voice.
Key Words
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Article info
Publication history
Published online: April 02, 2023
Accepted:
March 7,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
