The adult voice is perceived to change with advancing age. This more senescent voice is thought to result from multiple structural and functional changes that occur within the larynx as a normal part of the aging process. Structural changes may include atrophy of the intrinsic laryngeal musculature and ossification and degeneration of the cartilaginous portions of the larynx. Functional changes often include increased dryness and stiffness of the vocal fold mucosa as a result of both decreased glandular secretion as well as reduced elastin production. Most elderly people adjust for these gradual degenerative changes by using compensatory hyperfunctional voicing techniques (supraglottic contraction) and/or by improving breath support. However, the risk for eventual voice and swallowing decompensation is high, and it has been estimated that approximately 12% of the elderly have some degree of vocal dysfunction.
There is no accepted definition of what constitutes the normal aging voice, and little information is available regarding the prevalence of laryngeal pathology within this age group. This study was done to determine the prevalence of occult, or subclinical, laryngeal abnormality within an adult community-based cohort.
Read more: Occult laryngeal pathology in a community-based cohort
TODD R. REULBACH, MD, PETER C. BELAFSKY, MD, PhD, P. DAVID BLALOCK, MA, JAMES A. KOUFMAN, MD, and GREGORY N. POSTMA, MD, Winston-Salem, North Carolina