Park Jin, Alnouri Ghiath, Eichorn Daniel, Sataloff Robert T
Drexel University College of Medicine, Philadelphia, Pennsylvania.
Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
J Voice. 2022 May;36(3):413-416. doi: 10.1016/j.jvoice.2020.06.029. Epub 2020 Sep 11.
The normal aging process affects many human functions profoundly. The voice is no exception, and some aging effects on the voice are obvious including vocal fold atrophy, bowing, stiffness, more prominent vocal fold processes, and glottic insufficiency. The study's primary aim was to determine the correlation between presbylarynx and laryngeal electromyography (LEMG) results and to compare these electromyography (EMG) results with young and old voice patients without evidence of presbylarynx changes on strobovideolaryngoscopy.
Medical records for voice patients seen in the senior author's (RTS) practice between 2015 and 2019 were reviewed retrospectively. Patients with presbylarynx confirmed by strobovideolaryngoscopy were identified and compared to two control groups. The first control group included patients with ages and American Society of Anesthesiologists scores similar to the experimental group but no presbylarynx. The second control group included younger patients (ages ranging between 18 and 35 years with mean age of 24.57 years) with vocal fold paresis. All groups had undergone LEMG because of suspected paresis clinically. Social and medical factors reviewed and compared between groups included smoking history, alcohol consumption, occupation (voice demanding versus not voice demanding occupation), Voice Handicap Index score at the initial office visit, medical comorbidities, medications, and LEMG results.
There was no significant difference in the recruitment results for three pairs of muscles (cricothyroid, thyroarytenoid and posterior cricoarytenoid) between the presbylarynx group and both control groups. Rate of asthma was higher in presbylarynx group compared with the first control group. Rates of corticosteroid inhaler use, thyroid medications, smoking, and Voice Handicap Index score were higher in presbylarynx group compared with the second control group. There was no significant difference in occupation type and alcohol consumption between groups.
There was no significant difference found in the neuromuscular function based on laryngeal EMG between presbylarynx patients and both old and young patients with vocal fold paresis but without presbylarynx. Corticosteroid inhaler is associated with atrophic changes seen in presbylarynx. There still could be differences in the neuromuscular function which weren't detected. More research is needed to confirm or refute these findings.
正常的衰老过程会深刻影响许多人体功能。嗓音也不例外，衰老对嗓音的一些影响很明显，包括声带萎缩、弓状变形、僵硬、声带突更突出以及声门闭合不全。该研究的主要目的是确定老年嗓音与喉肌电图（LEMG）结果之间的相关性，并将这些肌电图（EMG）结果与频闪喉镜检查未发现老年嗓音变化的年轻和老年嗓音患者进行比较。
回顾性分析2015年至2019年资深作者（RTS）诊所中嗓音患者的病历。通过频闪喉镜检查确诊为老年嗓音的患者被识别出来，并与两个对照组进行比较。第一个对照组包括年龄和美国麻醉医师协会评分与实验组相似但无老年嗓音的患者。第二个对照组包括声带麻痹的年轻患者（年龄在18至35岁之间，平均年龄24.57岁）。由于临床上怀疑麻痹，所有组均接受了LEMG检查。在组间回顾和比较的社会和医学因素包括吸烟史、饮酒情况、职业（对嗓音有要求的职业与对嗓音无要求的职业）、初次就诊时的嗓音障碍指数评分、合并症、药物治疗以及LEMG结果。
老年嗓音组与两个对照组之间，三对肌肉（环甲肌、甲杓肌和后环杓肌）的募集结果无显著差异。老年嗓音组的哮喘发生率高于第一个对照组。老年嗓音组使用皮质类固醇吸入器、甲状腺药物、吸烟的比例以及嗓音障碍指数评分均高于第二个对照组。组间职业类型和饮酒情况无显著差异。
老年嗓音患者与声带麻痹但无老年嗓音的老年和年轻患者相比，基于喉肌电图的神经肌肉功能无显著差异。皮质类固醇吸入器与老年嗓音中出现的萎缩性变化有关。神经肌肉功能可能仍存在未被检测到的差异。需要更多研究来证实或反驳这些发现。
