Treatment effectiveness for aging changes in the larynx

Sachs, Aaron M.; Bielamowicz, Steven; Stager, Sheila V.

doi:10.1002/lary.26706

Cited by 17 publications

(22 citation statements)

References 32 publications

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“…Allensworth et al found a significant improvement in the VHI-30 (59.4-31.5) in 10 patients, which was very similar to the improvement found in our study (55.8-30.9) [20]. Contrary to our study where we only found an impact on fundamental frequency (males) and a transient effect in the dynamic range (patients with atrophy only), both Sachs and Allensworth showed improvements in several of the (semi-)objective parameters they analyzed [18,20]. As for patients with sulcus/scar, Welham et al showed a significant improvement in VHI-30 after treatment with thyroplasty in his series which did include unilateral procedures.…”

Section: Discussionsupporting

confidence: 89%

“…Shortly after this, Gore-tex ® medialization thyroplasty was introduced [11,14]. Since then several studies have reported on bilateral medialization thyroplasty in patients with glottic incompetence as a result of atrophy and sulcus, as well as paralysis, paresis, and other causes [6,7,[14][15][16][17][18][19][20][21][22][23]. The largest patient group (total n = 75, hypomobility n = 27, paresis n = 16, scarring n = 18, atrophy n = 14), which also has the longest follow-up (up to 10 years), showed overall improvement in voice-related quality of life (VRQOL).…”

Section: Discussionmentioning

confidence: 99%

“…Notably however, for the scar subgroup there was no statistically significant improvement in VRQOL [7]. Only a few additional studies have reported specifically on bilateral medialization thyroplasty in patients with atrophy or atrophy with sulcus/scar [6,18,20]. Sachs et al showed significant improvement in self-rating measures [VRQOL, Glottal Function Index (GFI) and a "best voice" Visual Analogue Scale (VAS)] in their patients with age-related atrophy treated with bilateral medialization thyroplasty [18].…”

Section: Discussionmentioning

confidence: 99%

“…Only a few additional studies have reported specifically on bilateral medialization thyroplasty in patients with atrophy or atrophy with sulcus/scar [6,18,20]. Sachs et al showed significant improvement in self-rating measures [VRQOL, Glottal Function Index (GFI) and a "best voice" Visual Analogue Scale (VAS)] in their patients with age-related atrophy treated with bilateral medialization thyroplasty [18]. Allensworth et al found a significant improvement in the VHI-30 (59.4-31.5) in 10 patients, which was very similar to the improvement found in our study (55.8-30.9) [20].…”

Section: Discussionmentioning

confidence: 99%

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Bilateral medialization thyroplasty in patients with vocal fold atrophy with or without sulcus

Broek

Heijnen

Hendriksma

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose To evaluate voice outcome after bilateral medialization thyroplasty in patients with non-paralytic glottic insufficiency due to vocal fold atrophy with or without sulcus. Methods Retrospective cohort study on 29 patients undergoing bilateral medialization thyroplasty for vocal fold atrophy (14 procedures) or atrophy with sulcus (15 procedures) between October 2012 and November 2017. Voice data were collected and analyzed for the preoperative and the 3-and 12-month postoperative time point according to a standardized protocol, including Voice Handicap Index (VHI)-30 and perceptual, acoustic and aerodynamic parameters. Failure rate was based on number of revisions within 12 months and non-relevant improvement (< 10 points) in VHI-30 at 12 months. Results There was a clinically relevant (≥ 15 points) and statistically significant improvement (p < 0.0001) in the VHI-30 (preoperative: 55.8 points; postoperative at 12 months: 30.9 points). Fundamental frequency for male subjects decreased significantly from 175 to 159 Hz (p = 0.0001). The pre-and post-operative grade of dysphonia was significantly lower in patients with atrophy compared to atrophy and sulcus (mean difference 0.70, p = 0.017). Conclusion Bilateral medialization thyroplasty is a valid treatment option for patients with atrophy with or without sulcus. Outcomes are comparable to other methods reported in literature. However, there is a great need for larger, prospective studies with long-term follow-up to gain more insight into the comparative voice outcomes for the different forms of surgery for patients with glottic incompetence due to atrophy with or without sulcus.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Bilateral medialization thyroplasty in patients with vocal fold atrophy with or without sulcus

Broek

Heijnen

Hendriksma

et al. 2020

Eur Arch Otorhinolaryngol

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“…Treatment of voice problems in the elderly can be beneficial for both voice outcomes and voice-related quality of life. 8 , 10 - 13 Optimizing management of voice problems in this patient population has important quality-of-life and health implications. Most studies have focused on patients identified through specialized otolaryngology or voice clinics and do not include self-reported voice improvement.…”

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confidence: 99%

Treatment Receipt and Outcomes of Self‐Reported Voice Problems in the US Population Aged ≥65 Years

Marmor

Misono

2018

OTO Open

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Objectives(1) Characterize the US population aged ≥65 years with self-reported voice problems, (2) describe voice treatment characteristics in this group, and (3) identify factors associated with self-reported voice improvement.Study DesignRetrospective cohort study.SettingPopulation-based cross-sectional US national survey sample.Subjects and MethodsWe identified a cohort of adults aged ≥65 years from the 2012 National Health Interview Survey, a population-based US national survey. Descriptive and multivariable regression analyses were performed.ResultsThe prevalence of self-reported voice problems in this cohort was 10%. Of those, 44% reported voice problems for >1 month. The strongest predictor of reporting voice improvement was receipt of voice treatment (odds ratio, 3.50; 95% confidence interval, 1.36-9.00), after adjusting for sex, age, race, education, and health status. Eleven percent reported voice treatment, which included 20% of those with moderate or worse voice problem severity. Female sex and worse health status were associated with reporting voice treatment. Among those with voice treatment, 38% reported “better,” 33% “same,” and 29% “worse” voice symptoms over the past year, compared to 17%, 67%, and 16%, respectively, among those without treatment. Health status influenced likelihood of reporting voice improvement but not universally.ConclusionsWe observed a significant self-reported burden of voice problems in the US population aged ≥65 years. Most are untreated and thus not well represented in the current literature. Vocal improvement was strongly associated with treatment. Further investigation is needed to clarify patient and treatment characteristics most associated with vocal improvement.

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Treatments for Age‐related Vocal Atrophy: A Systematic Review

et al. 2023

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ObjectiveAge‐related vocal atrophy (ARVA) can dramatically affect voice, communication, and quality of life. The objectives of this systematic review were to (1) determine whether treatments for ARVA were superior to controls (2) compare the relative efficacy of procedural and behavioral treatments (3) review the various types of outcome measures, and (4) evaluate the quality of studies.Review MethodsThe literature was searched using strategies designed by a medical librarian (2/18/21, updated 3/9/22). Studies investigating treatments for bilateral vocal atrophy were included. Studies involving unilateral atrophy, presbyphonia (without endoscopic findings), or an absent comparator group were excluded. The Preferred Reporting Items for Systematic Reviews and Meta‐analyses checklist was used to guide this study.ResultsAfter applying the inclusion/exclusion criteria, 8 articles remained, including 4 randomized trials and 4 cohort studies, and a narrative synthesis was performed. Surgical and behavioral treatments for ARVA appeared to be superior to control groups, based on specific outcome measures. However, the superiority of these treatments over controls was not uniformly observed across multiple outcome measures. When comparing different treatments, superiority could not be established based on the quality and completeness of the studies included in the systematic review. Outcome measures also varied between individual studies. Finally, the risk of bias was analyzed and scored. Consistent point deductions among reviewed studies were noted.ConclusionsWhen comparing treatments for ARVA. Surgery and voice therapy were both superior to control groups based on specific outcome measures from different domains. Superiority of one treatment could not be established.Level of EvidenceN/A Laryngoscope, 2023

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Treatment effectiveness for aging changes in the larynx

Abstract: 4. Laryngoscope, 127:2572-2577, 2017.

Cited by 17 publications

References 32 publications

Bilateral medialization thyroplasty in patients with vocal fold atrophy with or without sulcus

Bilateral medialization thyroplasty in patients with vocal fold atrophy with or without sulcus

Treatment Receipt and Outcomes of Self‐Reported Voice Problems in the US Population Aged ≥65 Years

Treatments for Age‐related Vocal Atrophy: A Systematic Review

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