This document discusses presbyphonia, which is an aging-related change in voice quality. As people age, the soft tissues of the larynx atrophy, reducing vocal fold tone and elasticity. Pulmonary function also declines with age, further impacting the voice. Clinically, presbyphonia presents with changes in pitch and intensity, decreased phonation time, vocal instability and tremor, breathiness, and vocal fatigue. Stroboscopy findings include bowed or concave vocal folds, glottic insufficiency, asymmetric vocal fold movement, and compensatory tremors. Treatment focuses on counseling, voice therapy, and exercises to improve breath support, as well as injection laryngoplasty or medialization thyro

1. Presbyphonia: Aging &Voice
Dr Shrikant Phatak
Head of ENT Department
Choithram Hospital & Research Center
Indore

2. Presbyphonia: Aging &Voice
Age related atrophy of the soft tissues of
the larynx results in reduction of the vocal
fold tone and elasticity influencing the voice
quality.
Declining pulmonary function related to the age
further adds to the problem.
Overall Reduction in social interaction

3. Presbyphonia: Aging &Voice
Clinical Presentation
1.Change in voice Males feel pitch is increased &
females feel it is lowered
2.Decreased intensity of voice
3.Decreased Phonation Time
4.Instability in the fundamental frequency Tremor
5.Increased breathiness of Voice
6.Vocal Fatigue.

4. Presbyphonia: Stroboscopy Findings
• Bowing & Concavity of the
vocal folds on abduction
• Glottic insufficiency
(phonatory gap)
• Asymmetric movement of
cords
• Compensatory tremor

5. Presbyphonia: Stroboscopy Findings
• Voice Difficultly heard in
background noise
• Feels like air leaking or
has to use extra force
while speaking
• Male feels pitch is
increased & females
feel it is lowered
Glottic insufficiency

6. Presbyphonia: Stroboscopy Findings
• Difficult to cope up with
the daily vocal demand
• Voice breaks or cracks
Asymmetric use of vocal
cords

7. Presbphonia: Stroboscopy Findings
• To compensate for
phonatory gap there is
anteroposterior
squeeze (yellow arrow)
• Overuse of false cords
(Red arrow)

8. Treatment
• Counseling &Voice therapy plays an
important role.
• Aim is to improve voice quality phonatory
exercises which facilitate breath support.
• Injection laryngoplasty
• Medialisation thyroplasty

9. Presbylarynx
• Thank you.

10. Disclaimer
• The information contained in the presentation is based on the personal
experience and cases collected at Choithram Hospital Indore over the last
20 years.
• It is intended for the use of Medical students ENT post graduates.
• The views expressed are purely on personal opinion. viewers can make
their own opinion. For any confusion please contact sole author.
• Everybody is allowed to copy or download the material best suited to him.
I am not responsible for any controversies arising out of the presentation.
• For any suggestions or corrections you may please contact
phatak_shrikant@yahoo.in