Geriatric Dysphonia and the most frequent diagnosis
DOI:
https://doi.org/10.34631/sporl.1051Keywords:
Geriatrics, Dysphonia, Presbyphonia, Presbylarynx, RefluxAbstract
Introduction: Aging is associated with a decline in voice quality, predisposing older adults to social withdrawal and introversion. It is therefore increasingly important to better understand the magnitude of dysphonia among geriatric patients and what laryngeal alterations are most commonly associated with the symptom.
Objective: to determine the prevalence of dysphonia among elderly patients referred from primary care to otorhinolaryngology and evaluate the commonest laryngeal findings underlying this symptom.
Methods: patients aged 65 and older referred from Primary Care to the Otorhinolaryngology department of a tertiary center during 2019 and 2020 were enrolled in this retrospective observational study. The exclusion criteria were the absence of videostroboscopy report and/or video recording in the patient ́s file,
Results: A total of 1304 patients were included in this study, with oto-neurologic symptoms as the main cause of referral (65%, n= 852), followed by Pharyngolaryngeal symptoms (17%, n=220) and Nasal symptoms (13%, n=167). The most prevalent findings were laryngopharyngeal reflux (44.81%, n=82), Presbylarynx (21.31%, n=39), vocal fold paresis or paralysis (5.46%, n=10), and vocal fold polyp (5.46%, n=10).
Conclusions: Geriatric dysphonia remains one of the common but undertreated health problems among the elderly, with this retrospective study cementing dysphonia as one of the main symptomatic complaints among geriatric patients. This enhances the need for a better preparation of otorhinolaryngologists for the evaluation and management of elderly patients presenting with dysphonia, recognizing the impact this symptom has on the day-to-day life of elderly patients.
References
Mirza N, Lee JY. Geriatric Otolaryngology. Otolaryngol Clin North Am. 2018 Aug;51(4):xvii-xviii. doi: 10.1016/j.otc.2018.04.002.
Chiu BL, Pinto JM. Aging in the United States: opportunities and challenges for otolaryngology-head and neck surgery. Otolaryngol Clin North Am. 2018 Aug;51(4):697-704. doi: 10.1016/j.otc.2018.03.001.
Kost KM. Geriatric otolaryngology: why it matters. Clin Geriatr Med. 2018 May;34(2):ix-x. doi: 10.1016/j.cger.2018.02.001.
Vaca M, Cobeta I, Mora E, Reyes P. Clinical assessment of glottal insufficiency in age- related dysphonia. J Voice. 2017 Jan;31(1):128.e1-128.e5. doi: 10.1016/j.jvoice.2015.12.010.
Yamauchi A, Imagawa H, Sakakaibara K, Yokonishi H, Ueha R, Nito T. et al. Vocal fold atrophy in a Japanese Tertiary Medical Institute: status quo of the most aged country. J Voice. 2014 Mar;28(2):231-6. doi: 10.1016/j.jvoice.2013.07.003.
Rapoport SK, Menier J, Grant N. Voice changes in the elderly. Otolaryngol Clin North Am. 2018 Aug;51(4):759-768. doi: 10.1016/j.otc.2018.03.012.
Applebaum J, Harun A, Davis A, Hillel AT, Best SRA, Akst LM. Geriatric dysphonia: characteristics of diagnoses in a tertiary voice clinic. Ann Otol Rhinol Laryngol. 2019 May;128(5):384-390. doi: 10.1177/0003489419826133.
Cohen SM, Turley R. Coprevalence and impact of dysphonia and hearing loss in the elderly. Laryngoscope. 2009 Sep;119(9):1870-3. doi: 10.1002/lary.20590.
Marino JP, Johns MM 3rd. The epidemiology of dysphonia in the aging population. Curr Opin Otolaryngol Head Neck Surg. 2014 Dec;22(6):455-9. doi: 10.1097/MOO.0000000000000098.
Lundy DS, Silva C, Casiano RR, Lu FL, Xue JW. Cause of hoarseness in elderly patients. Otolaryngol Head Neck Surg. 1998 Apr;118(4):481-5. doi: 10.1177/019459989811800409.
Mathew AS, Shilpa H. Geriatric Dysphonia: Etiological Analysis in a Rural Hospital in India. Indian J Otolaryngol Head Neck Surg. 2019 Jun;71(2):218-224. doi: 10.1007/s12070-018-1507-0.
Santos M, Freitas SV, Dias D, Costa J, Coutinho M, Sousa CA. et al. Presbylarynx: does body muscle mass correlate with vocal atrophy? A prospective case control study. Laryngoscope. 2021 Jan;131(1):E226-E230. doi: 10.1002/lary.28685.
Mendelsohn AH. The effects of reflux on the elderly: the problems with medications and interventions. Otolaryngol Clin North Am. 2018 Aug;51(4):779-787. doi: 10.1016/j.otc.2018.03.007.
Lechien JR, Finck C, Huet K, Khalife M, Fourneau AF, Delvaux V. et al. Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study. Eur Arch Otorhinolaryngol. 2017 Oct;274(10):3687-3696. doi: 10.1007/s00405-017-4671-z.
Azevedo SR, Santos M, Sousa F, Freitas S, Coutinho MB, Sousa CAE. et al. Validation of the Portuguese Version of the Voice Handicap Index-10. J Voice. 2020 Nov 20;S0892-1997(20)30410-0. doi: 10.1016/j.jvoice.2020.10.019.
Santos M, Sousa F, Azevedo S, Casanova M, Freitas SV, E Sousa CA. et al. Presbylarynx: is it possible to predict glottal gap by cut-off points in auto-assessment questionnaires? J Voice. 2020 Dec 28;S0892-1997(20)30451-3. doi: 10.1016/j.jvoice.2020.12.013.
Cervenka BP, Rao S, Bewley AF. Head and neck cancer and the elderly patient. Otolaryngol Clin North Am. 2018 Aug;51(4):741-751. doi: 10.1016/j.otc.2018.03.004.
Nocini R, Molteni G, Mattiuzzi C, Lippi G. Updates on larynx cancer epidemiology. Chin J Cancer Res. 2020 Feb;32(1):18-25. doi: 10.21147/j.issn.1000-9604.2020.01.03.
Tavaluc R, Tan-Geller M. Reinke's Edema. Otolaryngol Clin North Am. 2019 Aug;52(4):627-635. doi: 10.1016/j.otc.2019.03.006.
Park JC, Altman KW, Prasad VMN, Broadhurst M, Akst LM. Laryngeal Leukoplakia: State of the Art Review. Otolaryngol Head Neck Surg. 2021 Jun;164(6):1153-1159. doi: 10.1177/0194599820965910.
Lu FL, Presley S, Lammers B. Efficacy of intensive phonatory-respiratory treatment (LSVT) for presbyphonia: two case reports. J Voice. 2013 Nov;27(6):786.e11-23. doi: 10.1016/j.jvoice.2013.06.006.
Berg EE, Hapner E, Klein A, Johns MM 3rd. Voice therapy improves quality of life in age- related dysphonia: a case-control study. J Voice. 2008 Jan;22(1):70-4. doi: 10.1016/j.jvoice.2006.09.002.
Johns MM 3rd, Arviso LC, Ramadan F. Challenges and opportunities in the management of the aging voice. Otolaryngol Head Neck Surg. 2011 Jul;145(1):1-6. doi: 10.1177/0194599811404640.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
