Aging Voice pp 45-52 | Cite as

Clinical Assessment of Elderly Vocal Folds by Laryngoscopy



Laryngoscopy is an effective examination for assessing the morphological features of age-related vocal folds. In addition, disease-associated changes in the vocal folds in elderly people can also be diagnosed. Vocal fold atrophy is commonly identified as vocal fold bowing, which is characterized as a concaved edge of the vocal folds. The other typical disorder caused by atrophic changes in age-related vocal folds is sulcus vocalis. These changes are attributed to the volume reduction and degeneration of the extracellular matrix in the lamina propria in addition to atrophy of the intralaryngeal muscles. Stroboscopy is a useful and reliable method for examining vocal fold vibration. The reduced amplitude, aperiodic, and asymmetric vibration as along with the glottal gap are generally observed in elderly people with vocal fold atrophy. As such, both laryngoscopy and stroboscopy are better techniques not only to diagnose age-related vocal fold disorders, but also to evaluate disease-specific treatment.


Multiple System Atrophy Vocal Fold Vocal Fold Paralysis Spasmodic Dysphonia Unilateral Vocal Fold Paralysis 
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  1. 1.
    Yanagisawa E, Strothers G, Owens TW, Honda K. Videolaryngoscopy: a comparison of fiberscopic and telescopic documentation. Ann Otol Rhinol Laryngol. 1983;92(5):430–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Piazza C, Cocco D, Del Bon F, Mangili S, Nicolai P, Majorana A, et al. Narrow band imaging and high definition television in evaluation of oral and oropharyngeal squamous cell cancer: a prospective study. Oral Oncol. 2010;46(4):307–10.CrossRefPubMedGoogle Scholar
  3. 3.
    Woo P, Casper J, Colton R, Brewer D. Dysphonia in the aging. Laryngoscope. 1992;102(2):139–44.CrossRefPubMedGoogle Scholar
  4. 4.
    Hirano M, Kurita S, Sakaguchi S. Ageing of the vibratory tissue of human vocal folds. Acta Otolaryngol. 1989;107(5–6):428–33.CrossRefPubMedGoogle Scholar
  5. 5.
    Stell PM, Stell IM, Watt J. Age changes in the epithelial lining of the human larynx. Gerontology. 2009;28(3):208–14.CrossRefGoogle Scholar
  6. 6.
    Roberts T, Morton R, Al-Ali S. Microstructure of the vocal fold in elderly humans. Clin Anat. 2011;24(5):544–51.CrossRefPubMedGoogle Scholar
  7. 7.
    Sato K, Umeno H, Nakashima T. Functional histology of the macula flava in the human vocal fold. II. Its role in the growth and development of the vocal fold. Folia Phoniatr Logop. 2010;62(6):263–70.CrossRefPubMedGoogle Scholar
  8. 8.
    Rodeño MT, Sánchez-fernández JM, Rivera-pomar JM. Histochemical and morphometrical ageing changes in human vocal cord muscles. Acta Otolaryngol. 1993;113(3):445–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Takeda N, Thomas GR, Ludlow CL. Aging effects on motor units in the human thyroarytenoid muscle. Laryngoscope. 2000;110(6):1018–25.CrossRefPubMedGoogle Scholar
  10. 10.
    Shiba K, Isono S, Nakazawa K. Paradoxical vocal cord motion: a review focused on multiple system atrophy. Auris Nasus Larynx. 2007;34(4):443–52.CrossRefPubMedGoogle Scholar
  11. 11.
    Lundy DS, Silva C, Casiano RR, Lu FL, Xue JW. Cause of hoarseness in elderly patients. Otolaryngol Head Neck Surg. 1998;118(4):481–5.PubMedGoogle Scholar
  12. 12.
    Russell JA, Nagai H, Connor NP. Effect of aging on blood flow in rat larynx. Laryngoscope. 2008;118(3):559–63.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Bloch I, Behrman A. Quantitative analysis of videostroboscopic images in presbylarynges. Laryngoscope. 2001;111(11):2022–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Hirano M, Kurita S, Nakashima T. Growth, development, and aging of human vocal folds. In: Bless DM, Abbs JH, editors. Vocal fold physiology: contemporary research and clinical issues. San Diego: College-Hill Press; 1983. p. 23–43.Google Scholar
  15. 15.
    Sato K, Hirano M. Electron microscopic investigation of sulcus vocalis. Ann Otol Rhinol Laryngol. 1998;107(1):56–60.CrossRefPubMedGoogle Scholar
  16. 16.
    Bianchi AL, Denavit-Saubié M, Champagnat J. Central control of breathing in mammals: neuronal circuitry, membrane properties, and neurotransmitters. Physiol Rev. 1995;75(1):1–45.PubMedGoogle Scholar
  17. 17.
    Numasawa T, Shiba K, Nakazawa K, Umezaki T. Membrane potential changes in vocal cord tensor motoneurons during breathing, vocalization, coughing and swallowing in decerebrate cats. Neurosci Res. 2004;49(3):315–24.CrossRefPubMedGoogle Scholar
  18. 18.
    Biever DM, Bless DM. Vibratory characteristics of the vocal folds in young adult and geriatric women. J Voice. 1989;3(2):120–31.CrossRefGoogle Scholar
  19. 19.
    Linville SE. Source characteristics of aged voice assessed from long-term average spectra. J Voice. 2002;16(4):472–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Omori K, Kojima H, Slavit DH, Kacker A, Matos C, Blaugrund SM. Vocal fold atrophy: quantitative glottic measurement and vocal function. Ann Otol Rhinol Laryngol. 1997;106(7):544–51.CrossRefPubMedGoogle Scholar
  21. 21.
    Lindestad P-A, Hertegard S. Spindle-shaped glottal insufficiency with and without sulcus vocalis: a retrospective study. Ann Otol Rhinol Laryngol. 1994;103(7):547–53.CrossRefPubMedGoogle Scholar
  22. 22.
    Linville SE. The sound of senescence. J Voice. 1996;10(2):190–200.CrossRefPubMedGoogle Scholar
  23. 23.
    Rammage LA, Peppard RC, Bless DM. Aerodynamic, laryngoscopic, and perceptual-acoustic characteristics in dysphonic females with posterior glottal chinks: a retrospective study. J Voice. 1992;6(1):64–78.CrossRefGoogle Scholar
  24. 24.
    Gelfer MP, Bultemeyer DK. Evaluation of vocal fold vibratory patterns in normal voices. J Voice. 1990;4(4):335–45.CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  1. 1.Department of Otolaryngology-Head and Neck SurgeryKyoto Prefectural University of MedicineKyotoJapan

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