Treatments for Age‐related Vocal Atrophy: A Systematic Review

Bhatt, Neel K.; Garber, David; Baertsch, Hans; Beard, Lynly; Giliberto, John Paul; Meyer, Tanya K.; Meratı, Albert L.; Sauder, Cara

doi:10.1002/lary.30653

Cited by 9 publications

(4 citation statements)

References 51 publications

(216 reference statements)

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“…The clinical assessment of ARVA is largely non‐quantitative 7–9 . Clinicians typically rate the degree of vocal fold atrophy during laryngostroboscopy with descriptors such as mild , moderate , and severe atrophy 10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…The clinical assessment of ARVA is largely non-quantitative. [7][8][9] Clinicians typically rate the degree of vocal fold atrophy during laryngostroboscopy with descriptors such as mild, moderate, and severe atrophy. 10,11 There is no established definition of these descriptors making the clinical assessment of vocal fold atrophy inherently subjective.…”

Section: Introductionmentioning

confidence: 99%

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Streamlining quantification of age‐related vocal atrophy

Al‐Awadi,

Zughni,

Knutson

et al. 2024

Laryngoscope Investig Oto

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ObjectivesAge‐related vocal atrophy (ARVA) has a significant impact on voice, communication, and quality of life. Vocal folds are bowed with incomplete glottic closure during phonation. Efficient quantification of vocal fold atrophy and collection of voice recordings in clinic remains challenging. The primary focus of this study is to describe a novel method for quantifying vocal atrophy and obtaining voice recordings in clinic among patients with ARVA.MethodsPatients with ARVA were included. Voice recordings were collected during the clinic visit, and acoustic analysis was subsequently performed. A novel mobile application was used to quantify the bowing index (BI).ResultsThe study included 10 patients with ARVA, with a mean age of 72.7 ± 6.8 years and body mass index (BMI) of 24.9 ± 2.4 kg/m2. Calculation of BI was feasible with a mean of 9.9 ± 1.8 units. On average, the audio recording took 2.6 ± 0.4 min, and subsequent analysis required 7.1 ± 1.8 min. Mean continuous speech f0 was 212.1 ± 10.1 and 134.2 ± 31.5 Hz for male and female patients, respectively. Smoothed cepstral peak prominence was 8.9 ± 1.5 dB (male) and 8.5 ± 0.3 dB (female), and maximum phonation time between male and female patients was 16.7 ± 9.8 and 13.8 ± 1.9 s, respectively.ConclusionWe present a feasible and streamlined method for quantification of vocal fold atrophy in the clinic among patients with ARVA. The accuracy and reliability of this new method are areas of ongoing investigation. Quantification of vocal atrophy may help with clinical decisions, including diagnosing vocal atrophy and tracking treatment progress. Moreover, this method may improve research data acquisition without burdening patients and clinicians with additional time‐consuming tasks.Level of evidence: 4.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Streamlining quantification of age‐related vocal atrophy

Al‐Awadi,

Zughni,

Knutson

et al. 2024

Laryngoscope Investig Oto

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View full text Add to dashboard Cite

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“…Aging can dramatically affect voice and communication. 1,2 Laryngeal stroboscopy can show atrophic changes to the vocal folds, known as age-related vocal atrophy (ARVA). [3][4][5] ARVA has been reported to affect as many as 25% of elderly patients in the treatmentseeking population and can cause the voice to be breathy, strained, and weak.…”

Section: Introductionmentioning

confidence: 99%

“…Aging can dramatically affect voice and communication 1,2 . Laryngeal stroboscopy can show atrophic changes to the vocal folds, known as age‐related vocal atrophy (ARVA) 3–5 .…”

Section: Introductionmentioning

confidence: 99%

Quantitative Evaluation of Vocal Bowing Following Bilateral Thyroplasty in Age‐Related Vocal Atrophy

Cvancara,

Baertsch,

de Leon

et al. 2023

The Laryngoscope

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ObjectiveAge‐related vocal atrophy (ARVA) is associated with vocal fold bowing, persistent glottal gap during phonation, and dysphonia. Bilateral medialization thyroplasty is sometimes performed in patients with ARVA to improve vocal fold closure and voice. We set out to quantify stroboscopic changes in vocal fold bowing, glottal closure, and abduction angle following bilateral thyroplasty and determine how these changes affect voice quality among patients with ARVA.MethodsFifteen individuals with ARVA who underwent bilateral medialization thyroplasty were included in this study. Two independent investigators calculated bowing index (BI), normalized glottal gap area (NGGA), and maximum abduction angle from laryngostroboscopic exams using ImageJ™. Consensus Auditory‐Perceptual Evaluation of Voice (CAPE‐V) and patient‐reported measures were collected before and after thyroplasty.ResultsThyroplasty resulted in a 10‐point improvement in overall CAPE‐V (Mean dif −10; 95% CI –17, −3.3, p < 0.01) and VHI‐10 (mean dif −3.8; 95% CI –9.8, 2.3, p = 0.19, n = 8). NGGA and BI significantly decreased following surgery (mean dif −78; 95% CI –155, −1.5, p = 0.05; and mean dif −2.1; 95% CI –2.4, −0.84, p < 0.01, respectively). BI correlated with CAPE‐V scores (r = 0.66, 95% CI 0.22, 0.87, p < 0.01). When considering the normalized combined contributions of both NGGA and BI, there was a stronger correlation in CAPE‐V scores (r = 0.87, 95% CI 0.50, 0.97, p < 0.01) compared with either measure alone.ConclusionsThyroplasty resulted in a decrease in vocal fold bowing, glottal gap area, and CAPE‐V scores in patients with ARVA. Correction of vocal bowing and glottal gap, following bilateral thyroplasty, improved voice measures following surgery. Quantitative evaluation of vocal fold morphology may be valuable when assessing the severity and treatment‐response in patients with ARVA following bilateral thyroplasty. Laryngoscope, 2023

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Transcutaneous Laryngeal Ultrasound for Assessing Hyaluronic Acid Status in Patients Undergoing Injection Laryngoplasty

Chang,

Kuo,

Hsu

2024

The Laryngoscope

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ObjectiveInjection laryngoplasty (IL) with hyaluronic acid (HA) is an effective treatment for patients with glottic insufficiency. The duration of HA maintenance in the vocal fold remains unknown. In this study, transcutaneous laryngeal ultrasound (TLUS) was used to evaluate the absorption and migration of HA after IL. Subsequent management might be provided based on the TLUS finding.MethodsPatients diagnosed with unilateral vocal fold paralysis (UVFP) or vocal fold atrophy were recruited. All patients underwent IL with HA in an office‐based setting along with TLUS to monitor the status of HA. The schedule of TLUS included assessments before and after IL until non‐visualization.ResultsThe study population comprised 38 women and 17 men. Of the patients, 54.1% underwent IL for UVFP, whereas 45.9% underwent IL for vocal fold atrophy. Multivariate Cox regression analysis for factors affecting HA absorption revealed that the cause of injection was the most important independent predictor (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.03–4.46; p = 0.040). The duration of HA maintenance was significantly longer in patients with UVFP than in those with vocal fold atrophy (8.77 vs. 4.70 months, HR, 2.33; 95% CI, 5.47–8.18; p = 0.002).ConclusionTLUS is an objective assessment method for patients undergoing IL with HA. Subsequent tailor‐made management could be offered based on the TLUS findings during follow‐up. For patients at high risk of upper respiratory tract infection or who are intolerant to flexible nasopharyngoscopy, TLUS can be used as an alternative tool to evaluate the condition of the glottis after IL with HA.Level of EvidenceLevel 4 Laryngoscope, 2024

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Treatments for Age‐related Vocal Atrophy: A Systematic Review

Cited by 9 publications

References 51 publications

Streamlining quantification of age‐related vocal atrophy

Streamlining quantification of age‐related vocal atrophy

Quantitative Evaluation of Vocal Bowing Following Bilateral Thyroplasty in Age‐Related Vocal Atrophy

Transcutaneous Laryngeal Ultrasound for Assessing Hyaluronic Acid Status in Patients Undergoing Injection Laryngoplasty

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