Treatment Success Poor for Age-Related Vocal Fold Atrophy

What is the perceived treatment success for patients with vocal fold atrophy?

Background: Estimates for the number of elderly people with voice problems range from 4 percent to 30 percent. There are only a few published studies on voice therapy for age-related vocal fold atrophy and treatment outcomes of voice therapy and injection augmentation intervention. Additionally, it is unknown if improvements transferred to conversational speech as well as to the patients’ self-perception of their voice disorders.

Study design: Retrospective study.

Setting: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh.

Synopsis: Researchers reviewed 275 patients with vocal fold atrophy from January 2007 through January 2009 and used 29 percent as their estimate of the total population age 65 and older with dysphonia. They noted that only 15 percent to 20 percent of patients seek treatment. Therapy outcome measures used were pre/post-treatment Voice Handicap Index-10 and data from a voice therapy discharge survey. The treatment success for these patients was low (17 percent to 56 percent), and more than two-thirds of the cohort did not return for any treatment. More than half of the patients who only had surgery were judged to have improved. Many patients seemed unhappy with their treatment outcomes after voice therapy and/or surgery, however. The authors said a decrease in memory may cause increased patient frustration with therapy. They suggested pre-operative counseling to establish appropriate expectations.

Bottom line: Neither voice therapy nor surgery should be considered a certainty in helping patients with age-related vocal fold atrophy, and professionals should help patients with treatment expectations.

Citation: Gartner-Schmidt J, Rosen C. Treatment success for age-related vocal fold atrophy. Laryngoscope. 2011;121(3):585-589.

—Reviewed by Sue Pondrom