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Presbylaryngis (Vocal Fold Atrophy)

What is presbylaryngis?

As we age, muscle begins to atrophy. The vocal cords are composed of several important layers of tissue, but the fullness and shape of the vocal folds comes from the vocal cord muscle. Age-related vocal cord changes may include loss of volume and bowing (inward curvature) of the vocal cord inner edges, a condition termed presbylaryngis or presbyphonia. This may lead to a gap between the vocal cords during speaking, and other muscles may subsequently squeeze more tightly to compensate for reduced vocal cord closure. Other age-related changes to voice may be related to changes in hormones or mucous glands.

What are the symptoms of presbylaryngis?

Voice changes due to vocal cord atrophy are common in people over the age of 60 years. The most common symptoms include:

  • Reduced vocal volume

  • Higher pitched voice

  • Breathy, "thin" sound

  • Increased speaking effort

  • Vocal fatigue

  • Difficulty communicating with friends and family (especially with noise in the background or on the telephone)

Presbylaryngis Treatment

If you are diagnosed with vocal cord atrophy or presbylaryngis, voice therapy with a speech-language pathologist is the most common treatment. By focusing on improved vocal technique and better breath support, many people experience improvement in vocal volume, quality and endurance.

In some cases, your treatment team will discuss with you whether or not vocal cord augmentation is appropriate. This involves the injection of filler into one or both vocal cords to achieve straighter vocal cord edges and allow better vocal cord closure. Our experts have special expertise in performing this procedure in the clinic under local anesthesia.

Reviewed by Simon Best, M.D., from the Department of Otolaryngology-Head and Neck Surgery.

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