Quantitative Analysis of Videostroboscopic Images in Presbylarynges

Abstract

Bowing does not consistently predict the extent of glottal gap. Therefore, other presbylaryngeal changes are probably contributing to incomplete glottal closure, which are not well-visualized stroboscopically, so the finding of bowing is not sufficiently specific to identify presbylarynges. The significantly smaller normalized laryngeal outlet values suggest that this identifies a compensatory strategy for glottal gap to optimize vocal function. This is a novel finding that contrasts with medial ventricular fold squeezing, which is more routinely sought and is typically considered a maladaptive compensatory strategy. Despite the advantages of quantitative stroboscopic measures, limitations in reliability limit their clinical utility.

Effects of age on the amplitude, frequency and perceived quality of voice

“…In particular, older adults had lower minimum, maximum and mean f0 and amplitude SD values compared with younger adults for sustained vowels, but similar f0 and amplitude SD values compared with younger adults for connected speech. Because speech fundamental frequency is due to the physiological characteristics of the vocal folds and control of the larynx musculature (Honjo and Isshiki 1980;Bloch and Behrman 2001;Baken 2005;Sato et al 2011), the absence of change observed in mean and range speech fundamental frequency here suggests that the state of the tissue and general motor control did not deteriorate with age (at least in the age range studied), or did not deteriorate enough to have a functional impact. These results indicate that, while sustained vowel production was affected negatively by age, connected speech was less vulnerable to age.…”

“…In particular, physiological changes occur in the larynx (Honjo and Isshiki 1980;Bloch and Behrman 2001;Ximenes Filho et al 2003;Kersing and Jennekens 2004;Pontes et al 2005Pontes et al , 2006Sato et al 2010Sato et al , 2011, the vocal tract (Pontes et al 2006), and the respiratory system (Linville 1996;Teles-Magalhães et al 2000;Ramig et al 2001;Sauder et al 2010). These changes include calcification and ossification of cartilages, muscles and vocal fold atrophy, vocal fold bowing (i.e., inward curve) and reduced mucosal wave, and reduced pulmonary lung pressures, volumes, elasticity, and recoil.…”

Características supraglóticas de idosos: relações com a função de deglutição

“…Apesar das manifestações do envelhecimento laríngeo serem bastante individuais, são comuns a presença de saliência dos processos vocais, do arqueamento de pregas vocais, da fenda glótica durante fonação (PONTES; BRASOLOTTO;BEHLAU, 2005;YAMASAKI;BEHLAU, 2006;SANTOS, 2011;YAMAUCHI et al, 2015), além de constrição supraglótica (HAGEN; LYON; NUSS, 1996;BLOCH;BEHRMAN, 2001;YAMASAKI;BEHLAU, 2006;STAGER;BIELAMOWICZ, 2010). Frente às alterações decorrentes do envelhecimento das estruturas responsáveis pela fonação, é comum ocorrerem alterações vocais.…”

“…Dentre as características laríngeas do idoso, a região supraglótica, frequentemente apresenta-se com aumento de volume das pregas vestibulares durante a respiração e movimento de constrição mediana e/ou anteroposterior durante a fonação (HAGEN;LYON;NUSS, 1996;BLOCH;BEHRMAN, 2001;YAMASAKI;BEHLAU, 2006;STAGER;BIELAMOWICZ, 2010). Estes aspectos são considerados como reações compensatórias ao fechamento glótico insuficiente durante a fonação e diversas abordagens terapêuticas para presbifonia, têm o objetivo de melhorar o fechamento glótico e reduzir a constrição supraglótica (LAGORIO; CARNABY-MANN;CRARY, 2010;GODOY, 2016).…”

“…Dentre os casos em que não foi observado resíduo em laringofaringe, mais de 90% apresentou constrição mediana na fala. PINHO et al, 1999;BLOCH;BEHRMAN, 2001;STAGER et al, 2003;JAISWAL;FINNEGAN, 2007;ZHENG et al, 2009;STAGER;BIELAMOWICZ, 2010). Tal comportamento pode causar a hipertrofia do músculo tireoaritenoide e o consequente aumento de volume das pregas vestibulares (KOSOKOVIĆ et al, 1977;VON DOERSTEN et al, 1992).…”